Unmet need for patients with metastatic triple-negative breast cancer initiating first-line treatment: data from the prospective German tumor registry OPAL.

Background: The treatment landscape for metastatic triple-negative breast cancer (mTNBC) has evolved. However, data on implementation of novel treatment approaches in clinical routine and current real-world outcomes are limited. Patients and methods: Patients with mTNBC who initiated first-line (1L) treatment between January 2018 and August 2023 were prospectively observed within the OPAL registry. Treatment patterns, median real-world overall survival (rwOS), and progression-free survival (rwPFS) were analyzed by programmed death-ligand 1 (PD-L1) status. Results: Among 368 patients included in this analysis, 31.8% were PD-L1 positive, 35.9% PD-L1 negative, and 32.3% PD-L1 unknown. Median age was 62.0 years, 10.6% had an Eastern Cooperative Oncology Group performance status ≥2, and 37.8% had Conclusions: Although new treatment options have been rapidly integrated into clinical routine, chemotherapy remains standard for most patients in 1L. Survival remains poor, with at least one-quarter dying without reaching 2L. This highlights the need for novel therapies to improve mTNBC outcomes.