Update on Triple Negative Breast Cancer
As most of you know, triple negative breast cancer refers to cancers that are ER negative, PR negative, and her2 negative. By definition, these cancers are not going to be helped by any therapies that are targeted to the above features. This means that all of the hormonal/anti-estrogen treatments and herceptin and herceptin second generation drugs are irrelevant in the care of women with triple negative tumors.
On the positive side, triple negative breast cancers are particularly sensitive to chemotherapy. Many women, however, are especially scared by this diagnosis and wish that more treatments were available to them. There is a lot of research going on to try to identify targets within these tumors, and there are some developing clinical trials in the advanced stage setting as well as in neoadjuvant therapies.
Here is a good summary from Living Beyond Breast Cancer. Per usual, I give you a quote and the link:
April 2014 Ask the Expert: Medical Updates,
Treatment Options and Follow-Up Care for Triple-Negative Breast Cancer
Rita Nanda, MD
Question: Are there any targeted therapies ready to be approved for triple-negative breast cancers?
Dr. Nanda: Currently, there are no targeted therapies FDA approved for TNBC. A wide variety of targeted treatments for TNBC are currently being studied, primarily in the neoadjuvant—prior to surgery—and advanced/metastatic cancer settings.
At the San Antonio Breast Cancer Symposium held in December of 2013, a presentation was given on a phase II trial evaluating the addition of the PARP inhibitor veliparib (ABT-888) and the chemotherapy drug carboplatin to standard chemotherapy—with paclitaxel, doxorubicin, and cyclophosphamide. Pathological response rates improved when veliparib and carboplatin were added to standard chemotherapy.
A phase III study testing this combination versus the standard of care in the NACT setting is currently being planned and will soon be underway. A number of other targeted therapies are currently being studied in the advanced cancer setting, including immune therapies and medicines that target pathways believed to lead to chemotherapy resistance.