Triple negative breast cancer (TNBC) is a heterogeneous disease entity constituting about 15% of breast
cancer cases worldwide. TNBC is associated with poor prognosis and lack of sustained response to conventional
chemotherapeutic agents. Tumoral heterogeneity and the presence of several subtypes of TNBC such as Basal like
(BL)-1, BL-2, immune-modulatory, luminal androgen receptor, mesenchymal, and mesenchymal/stem like subtype
and claudin low subtype, may explain some of the difficulties faced in managing this challenging disease subgroups.
Although no approved targeted therapy is available for TNBCs, molecular-profiling efforts have revealed promising
molecular targets such as the vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR),
polyadenosine ribose polymerase inhibitors (PARPi) and DNA repair pathway, androgen pathway, and NOTCH
pathway. TNBC is subject to intense research activities aiming at dissecting potential pathways, identifying potential
molecular signatures and biomarkers in order to properly develop new targeted biologic modifiers. Despite this, there
is a lack of approved predictive and prognostic biomarkers, and keeping in view the complexity of TNBC biology,
research should be targeted towards identifying multi-factorial signatures rather than single markers. This review aims
to summarize the current evidence, ongoing research and discuss future strategies for the treatment of patients with
TNBC. In addition we have reviewed the recent advances in detecting predictive and prognostic biomarkers and
identifying surrogate markers for early identification of potential responders to the new therapies.