How would you approach further systemic treatment after definitive local treatment for patients with locally advanced TNBC that had early local progression through neoadjuvant AC-T, adjuvant cape and adjuvant RT?

If the patient is currently NED, I would not administer further systemic therapy, as there is no evidence that additional treatment will improve outcomes. As oncologists, we are sometimes tempted to 'do something' in situations where we expect the prognosis to be poor, but where there is no evidence that additional treatment will benefit the patient, I think we must resist that temptation, as all too often we are only increasing toxicity—except to offer the patient the opportunity to participate...