Triple–negative breast cancer (TNBC) is an aggressive subtype accounting for ~10–20% of all human BC and is characterized by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) amplification. Owing to its unique molecular profile and limited targeted therapies, TNBC treatment poses significant challenges. Unlike other BC subtypes, TNBC lacks specific molecular targets, rendering endocrine therapies and HER2–targeted treatments ineffective. The chemotherapeutic regimen is the predominant systemic treatment modality for TNBC in current clinical practice. However, the efficacy of chemotherapy in TNBC is variable, with response rates varying between a wide range of patients, and the emerging resistance further adds to the difficulties. Furthermore, TNBC exhibits a higher mutational burden and is acknowledged as the most immunogenic of all BC subtypes. Consequently, the application of immune checkpoint inhibition has been investigated in TNBC, yielding promising outcomes. Recent evidence identified extracellular vesicles (EVs) as an important contributor in the context of TNBC immunotherapy. In view of the extraordinary ability of EVs to transfer bioactive molecules, such as proteins, lipids, DNA, mRNAs, and small miRNAs, between the cells, EVs are considered a promising diagnostic biomarker and novel drug delivery system among the prospects for immunotherapy. The present review provides an in–depth understanding of how EVs influence TNBC progression, its immune regulation, and their contribution as a predictive biomarker for TNBC. The final part of the review focuses on the recent key advances in immunotherapeutic strategies for better understanding the complex interplay between EVs and the immune system in TNBC and further developing EV–based targeted immunotherapies.
三阴性乳腺癌（TNBC）是一种侵袭性亚型，约占所有人类乳腺癌的10%–20%，其特征为缺乏雌激素受体（ER）、孕激素受体（PR）以及人表皮生长因子受体2（HER2）扩增。由于其独特的分子特征及有限的靶向治疗手段，TNBC的治疗面临重大挑战。与其他乳腺癌亚型不同，TNBC缺乏特异性分子靶点，导致内分泌治疗及HER2靶向治疗无效。化疗方案是目前临床实践中TNBC的主要全身治疗方式。然而，化疗在TNBC中的疗效存在差异，患者间的应答率波动较大，且不断出现的耐药性进一步增加了治疗难度。此外，TNBC具有较高的突变负荷，被公认为所有乳腺癌亚型中免疫原性最强的类型。因此，免疫检查点抑制剂在TNBC中的应用已得到研究，并显示出良好前景。近期证据表明，细胞外囊泡（EVs）在TNBC免疫治疗中发挥着重要作用。鉴于EVs能够在细胞间传递蛋白质、脂质、DNA、mRNA及微小miRNA等生物活性分子的卓越能力，其在免疫治疗前景中被视为一种有潜力的诊断生物标志物及新型药物递送系统。本综述深入探讨了EVs如何影响TNBC进展及其免疫调控机制，并阐述了其作为TNBC预测性生物标志物的作用。综述最后部分聚焦于免疫治疗策略的最新关键进展，以更好地理解TNBC中EVs与免疫系统之间复杂的相互作用，并进一步推动基于EVs的靶向免疫治疗的发展。
肿瘤(癌症)患者之家