ObjectiveTo sort out the key evidence-based data and recent advances in the systemic treatment of advanced triple-negative breast carcinoma (TNBC), to summarize the therapeutic strategies so as to provide guidance for clinical practice. MethodsThe key evidence and research progress on immune checkpoint inhibitors, antibody–drug conjugates (ADCs), poly ADP-ribose polymerase (PARP) inhibitors, anti-angiogenic agents, and novel microtubule inhibitors were summarized. ResultsThe treatment landscape for advanced TNBC has shifted from chemotherapy-centric approaches to biomarker-driven, stratified precision therapy. Based on programmed cell death ligand 1 (PD-L1) expression levels, immune therapy combined with chemotherapy is prioritized. For cases with germline breast cancer gene 1/2 (gBRCA1/2) mutations, PARP inhibitors are recommended. ADCs are suggested for second-line treatment, while novel microtubule inhibitors, either alone or in combination with anti-angiogenic agents, are preferred for later-line therapy to extend patient survival. ConclusionDynamic monitoring of molecular biomarkers such as PD-L1 and gBRCA, combined with sequential or combined "targeted–immunotherapy–ADC" regimens in a "chemotherapy-free" approach, has shown promise in improving overall survival in advanced TNBC.