Triple-Negative Breast Cancer
This review will focus on the molecular and clinicopathologic features, epidemiology and risk factors, prognosis, and current and future therapeutic strategies for patients diagnosed with triple-negative breast cancer, including a brief discussion of intracranial disease.
Triple-Negative Breast Cancer
In order for malignancies to establish in metastatic sites, cancer cells must acquire attributes of those sites; specifically how this occurs in many cancers is relatively unknown, but a new study implicates the stroma of certain breast cancer tumors in the development of bone metastases.
Clearly there is no single therapy for all patients with TNBC, given the molecular heterogeneity of this subtype. However, new insights from further genomic analysis of TNBC suggest approaches to rational clinical trial design, and patients will undoubtedly benefit as we define the most appropriate therapeutic targets in management of this aggressive disease.
Triple-negative breast cancer (TNBC) remains a very challenging entity today, but with the identification of new targets and further optimization of therapy, the landscape for TNBC may not look so negative. In the future, “TNBC” may be considered an antiquated misnomer, as we will have identified various breast cancer subgroups based on what they “are” rather than what they “are not.”
With regard to potential research strategies relevant to the treatment of triple-negative breast cancer/basal-like breast cancer, potential targets include PTEN, INPP4B, PIK3CA, KRAS, BRAF, EGFR, FGFR1, FGFR2, IGFR1, KIT, MET, PDGFRA, and the HIF1-α/ARNT pathway. Many of these will be discussed further in this review article.
In a study presented at ASCO, a team of researchers used microarrays to characterize 130 triple-negative breast cancer patients treated with neoadjuvant chemotherapy to see whether certain subtypes are more likely to respond to the treatment.
Washington, DC—“Triple-negative breast tumors are composed of mosaic cancer cells with distinct genetic aberrations,” said Jorge S. Reis-Filho, MD, PhD, a surgical pathologist at the Memorial Sloan-Kettering Cancer Center in New York, who combines traditional pathology, gene expression profiling, and genomics techniques to understand rare breast tumor types, including triple-negative diseases.
Additional insight into the biology of ER-positive breast cancers, particularly the higher risk luminal B cancers, could aid in identifying potential targets and new, effective therapies. And though the majority of triple-negative breast cancers are the “basal-like” subtype, significant proportions are in other subtypes.
To kick off SABCS 2012, we discuss the use of molecular testing for the diagnosis and treatment of breast cancer patients in the clinical setting with Dr. Antonio Wolff of the Kimmel Cancer Center at Johns Hopkins University, one of the presenter's during the "Practical Use of Molecular Profiling" session at this year's symposium.
Triple-negative breast cancer is aggressive, has a high rate of metastases, and carries a poor prognosis. Dr. Joyce O’Shaughnessy, who will be presenting at the Miami Breast Cancer Conference, discusses an overview of new therapies for triple-negative breast cancer.
Dr. Gunter von Minckwitz discusses the recent paper he authored that showed that bevacizumab in addition to neoadjuvant chemotherapy significantly increased the rate of pathological complete response in patients with early stage HER2-negative breast cancer.
The early promise of treating triple-negative and basal-cell breast cancers with poly (ADP-ribose) polymerase (PARP) inhibitors is yet to be realized, according to Lisa A. Carey, MD, who will be delivering a presentation on treatment options for these patients at the Miami Breast Cancer Conference this week.