New Treatments Bring Hope for Triple Negative Breast Cancer

Promising New Treatments Bring Hope for Triple Negative Breast Cancer

Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer that accounts for 10-20% of breast cancer cases. Unlike other types of breast cancer, TNBC lacks estrogen receptors, progesterone receptors and excess HER2 protein, so it does not respond to hormonal or HER2-targeted treatments.

In the past, chemotherapy was the main treatment option for TNBC. But outcomes for TNBC have historically been worse than for other breast cancers. The good news is that research on TNBC has exploded in recent years, bringing new treatment approaches that are dramatically improving prognosis.

Understanding Triple Negative Breast Cancer

TNBC gets its name from testing negative for:

• Estrogen receptors (ER)
• Progesterone receptors (PR)
• HER2 (human epidermal growth factor receptor 2) overexpression

Around 80% of TNBC cases are also basal-like breast cancers. Basal-like means the cancer cells resemble the basal cells that line the breast ducts. TNBC also overlaps with BRCA-mutation associated breast cancers.

Key features of TNBC include:

• Aggressive growth and spread
• Higher risk of recurrence
• Poor prognosis with chemotherapy alone
• More common in younger and African-American women

Growth in TNBC Treatment Options

Better understanding the biology of TNBC is fueling development of new targeted therapies. Exciting treatment advances include:

Immunotherapy

Immunotherapy drugs help empower the immune system to attack cancer. The immunotherapy atezolizumab (Tecentriq) was approved in 2019 for advanced TNBC based on improved survival compared to chemotherapy.

PARP Inhibitors

PARP inhibitors like olaparib (Lynparza) block the PARP enzyme cancer cells need to repair DNA damage. PARP inhibitors prolong progression-free survival in metastatic TNBC with BRCA mutations.

Antibody-Drug Conjugates

Antibody-drug conjugates (ADCs) combine an antibody that targets cancer cells with a chemotherapy payload. Sacituzumab govitecan (Trodelvy) became the first ADC approved for previously treated advanced TNBC in 2020.

Targeted Therapies

New drugs target specific mutations, pathways and processes in cancer growth and spread. Promising options being tested include VEGF, PI3K, AKT, MEK inhibitors and more.

Combination Treatments

Research on using immunotherapy, PARP inhibitors, ADCs and other new drugs together and combined with chemotherapy is ongoing. Combinations often boost effectiveness.

Improved Outcomes with New TNBC Treatments

Just 5 years ago, median overall survival for metastatic TNBC was around 1 year. The additions of immunotherapy, PARP inhibitors and antibody-drug conjugates are extending lives by months to years for many patients.

In early stage TNBC, new targeted treatments given before or after chemotherapy are reducing recurrence rates. More women are experiencing long-term remission, especially when therapies are personalized based on tumor profiling.

Higher Response Rates

With chemotherapy alone, only around 10-20% of women with metastatic TNBC responded by having their tumors shrink substantially. New immunotherapies, ADCs and PARP inhibitors are achieving response rates of 30-50% in clinical trials.

Longer Progression-Free Survival

Progression-free survival (PFS), the time before cancer growth resumes, is increasing with new treatments. PFS is doubling from around 3-6 months to 6-12+ months for many patients.

Improved Overall Survival

Before recent treatment advances, 5-year survival was only around 12% for stage IV TNBC. Now median overall survival is extending out to 2+ years in many cases. More good news is coming as new combinations are tested.

The Future Looks Brighter for TNBC

In 2022, triple negative breast cancer remains a challenging diagnosis. But the future looks much brighter thanks to an explosion of promising new treatments on the horizon.

More options are helping shift TNBC into a chronic rather than terminal disease for many patients when detected early. Researchers also foresee the potential to make late stage TNBC largely survivable in the coming decade.

More Targeted Therapies Coming

Dozens of new targeted drugs for TNBC are in the pipeline, including promising immunotherapy combinations. More approvals are expected in the next 5 years as current trials read out.

Improved Drug Delivery

New delivery mechanisms are enhancing effectiveness of treatments. Nanotechnology and antibody-drug conjugates allow targeting just tumor cells while reducing side effects.

Biomarker-Guided Treatment

Identifying predictive biomarkers is enabling more personalized, precise therapy based on the molecular profile of each patient's cancer.

Supportive Care Optimized

Better management of treatment side effects and supportive care continues improving patients' quality of life and ability to complete recommended therapy.

Expanded Access to Care

Increasing awareness and access to genetic testing, screening, diagnosis and optimal treatment for all populations remains a priority.

Key Takeaways

The highlights covered here demonstrate that the prognosis for triple negative breast cancer is improving rapidly thanks to scientific research:

• New immunotherapy, targeted therapy and ADC options are increasing response rates and survival.
• Combination treatments are proving even more effective than single drugs.
• Biomarker-guided precision medicine allows more personalized treatment.
• Supportive care helps patients complete therapy and maintain quality of life.
• Research continues expanding current knowledge and tools for fighting TNBC.

While more work remains, the future is undeniably brighter for triple negative breast cancer patients. Ongoing advances provide real hope that TNBC can become a very treatable diagnosis for the vast majority of patients in the years ahead.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.