The Impact of Novel Therapies on Quality-of-Life in Triple-Negative Breast Cancer: A Systematic Review of Clinical Trials
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Department of Biomedical Research, St. George’s University, University Centre Grenada, St. George's GE01, Grenada
2
Department of Hematology and Oncology, The Brooklyn Cancer Center, Brooklyn, NY 11201, USA
3
Department of Hematology and Oncology, New York Cancer & Blood Specialists, New York, NY 10026, USA
*
Author to whom correspondence should be addressed.
Cancers 2025, 17(20), 3307; https://doi.org/10.3390/cancers17203307
Submission received: 9 August 2025
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Revised: 1 October 2025
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Accepted: 3 October 2025
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Published: 13 October 2025
(This article belongs to the Section Systematic Review or Meta-Analysis in Cancer Research)
Simple Summary
Triple-negative breast cancer (TNBC) is an aggressive form of breast cancer with limited treatment options and poor clinical outcomes. Recently, novel therapies, such as immunotherapy (e.g., pembrolizumab), antibody–drug conjugates (e.g., sacituzumab govitecan), and targeted treatments (e.g., PARP inhibitors like olaparib and talazoparib), have been introduced to expand therapeutic options. This systematic review evaluated clinical trials to assess how these novel therapies affect patients’ quality of life (QoL) compared to traditional chemotherapy. Results indicated that some novel therapies, particularly sacituzumab govitecan and PARP inhibitors, showed improvements in patient QoL, delaying deterioration in physical and emotional health. However, immunotherapies showed mixed results with insignificant QoL benefits.
Abstract
Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype characterized by poor prognosis and limited therapeutic options. Chemotherapy regimens are associated with significant adverse effects negatively impacting patients’ quality of life (QoL). This systematic review aims to evaluate and compare QoL outcomes of patients with TNBC receiving novel therapies—including immunotherapy, antibody–drug conjugates, and targeted therapies—versus standard chemotherapy. Methods: We systematically reviewed randomized controlled trials (RCTs) published within the past 15 years, identified through comprehensive searches in PubMed, Google Scholar, Research4Life, and Elicit. Included studies involved FDA-approved novel therapies (pembrolizumab, atezolizumab, sacituzumab-govitecan, olaparib, and talazoparib) administered to TNBC patients, and assessed QoL using validated tools such as EORTC QLQ-C30. Observational studies, case reports, and non-standardized assessments were excluded. Results: Eight RCTs comprising 3929 patients met the inclusion criteria. Sacituzumab govitecan and PARP inhibitors (olaparib and talazoparib) significantly improved QoL, notably delaying deterioration across physical, emotional, and functional domains compared to standard chemotherapy. Conversely, immunotherapies (pembrolizumab, atezolizumab) showed non-significant trends toward QoL improvement, with effects varying by patient subgroup and disease stage. Interpretation was limited by study design differences, inconsistent compliance, and incomplete data reporting. Conclusions: Immunotherapy showed a neutral effect on quality of life, providing neither significant improvement nor additional decline. Olaparib was associated with a delayed deterioration in quality of life, showing a more favorable tolerability profile compared to chemotherapy. Talazoparib leads to clinically meaningful enhancements in quality of life, while sacituzumab govitecan effectively improves patient-reported outcomes relative to standard chemotherapy.
