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Triple-Negative Ca’s Respond to Optimized Taxane Chemotherapy

Triple-Negative Ca’s Respond to Optimized Taxane Chemotherapy

CHICAGO--Gene expression arrays
have extended the identification of
molecular subtypes of breast cancer
beyond the presence or absence of the
estrogen receptor (ER) and revealed the
multiplicity of diseases within the breast
cancer umbrella that have different prognoses.
One of these subtypes is the
so-called triple-negative form of breast
cancer, or basal-like breast cancer, which
occurs in 10% to 20% of tumors. Such cancers have low expression of HER2,
ER, and progesterone-receptor (PR), and
are highly proliferative.

The other molecular subtypes are
commonly described as luminal A (ER+,
HER2-); luminal B (ER+, HER2+);
HER2 (HER2+, ER-), and normal-like
(negative for all markers) (see Table on
page 29).

While endocrine and HER2-targeted
therapies have been effective in the treatment of patients with luminal A, luminal
B, and HER2 subtypes of breast cancer,
only chemotherapy has been an option
for patients with basal-like breast cancer.

The Good News
"The only treatment is chemotherapy.
That's the bad news. The good news is
that it does work," Lisa A. Carey, MD,
associate professor of medicine, University
of North Carolina School of Medicine, The Good News
"The only treatment is chemotherapy.
That's the bad news. The good news is
that it does work," Lisa A. Carey, MD,
associate professor of medicine, University
of North Carolina School of Medicine,
Chapel Hill, said at the 8th Annual
Lynn Sage Breast Cancer Symposium.

Less than 10% of patients with luminal
A/B or normal-like subtypes of breast
cancer have a pathological complete response
to paclitaxel followed by fluorouracil,
doxorubicin, and cyclophosphamide
(T-FAC) or doxorubicin and
cyclophosphamide followed by paclitaxel
or docetaxel (Taxotere) (AC-T), compared
with 26% to 45% of patients with basal-like breast cancer.

In a study of 82 patients treated with
T-FAC, a pathological complete response
was detected in only 2 of 30 (7%) patients
with luminal A/B breast cancer and
0 of 10 (0%) patients with normal-like
disease. However, 10 of 22 patients (45%)
with basal-like breast cancer had a documented
complete response to the regimen,
as did 9 of 20 (45%) HER2+
patients.

In a study of 107 breast cancer patients
who were treated with AC-T, only
4 of 62 (7%) patients with luminal A/B
breast cancer had a complete response,
compared with 9 of 34 (26%) patients
with basal-like breast cancer.

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