Figure 2. Management of Metastatic Triple Negative Breast
Cancer
Patients with metastatic triple
negative breast cancer
(First Line)
PD L1 positive?
Single agent chemotherapy is the
preferred option, but combination
regimens may be offered for symptomatic
or immediately life-threatening disease
NO
YES
Progressive disease
Immune checkpoint
inhibitor with
chemotherapy
(atezolizumab plus
nab-paclitaxel or
pembrolizumab plus
chemotherapy)
Oral PARP
inhibitor in the
first through
third line
setting
YES
Germline BRCA1
or 2
mutations?
Sacituzumab govitecan
NO
