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.
背景：三阴性乳腺癌是一种侵袭性乳腺癌亚型，其特点是预后不良且治疗选择有限。化疗方案常伴随显著的不良反应，对患者生活质量产生负面影响。本系统综述旨在评估并比较接受新型疗法（包括免疫疗法、抗体药物偶联物和靶向疗法）与标准化疗的三阴性乳腺癌患者的生活质量结局。 方法：我们系统回顾了过去15年内发表的随机对照试验，通过PubMed、Google Scholar、Research4Life和Elicit进行全面检索。纳入的研究涉及美国食品药品监督管理局批准的新型疗法（帕博利珠单抗、阿特珠单抗、戈沙妥珠单抗、奥拉帕利和他拉唑帕利）用于三阴性乳腺癌患者，并使用欧洲癌症研究与治疗组织生活质量核心问卷等验证工具评估生活质量。观察性研究、病例报告和非标准化评估被排除在外。 结果：八项随机对照试验共纳入3929名患者符合纳入标准。与标准化疗相比，戈沙妥珠单抗和聚腺苷二磷酸核糖聚合酶抑制剂（奥拉帕利和他拉唑帕利）显著改善了生活质量，尤其在身体、情感和功能领域延缓了生活质量恶化。相反，免疫疗法（帕博利珠单抗、阿特珠单抗）在生活质量改善方面显示出不显著的趋势，其效果因患者亚组和疾病阶段而异。研究设计差异、依从性不一致以及数据报告不完整限制了结果的解读。 结论：免疫疗法对生活质量呈中性影响，既未显著改善也未导致额外下降。奥拉帕利与生活质量恶化延迟相关，显示出比化疗更有利的耐受性特征。他拉唑帕利带来具有临床意义的生活质量提升，而戈沙妥珠单抗相较于标准化疗能有效改善患者报告结局。
肿瘤(癌症)患者之家