Triple-Negative Breast Cancer – TNBC

Triple-negative breast cancer is characterized by the absence of estrogen receptors, progesterone receptors, and an overabundance of human epidermal growth factor (HER2) protein.

These findings indicate that the cancer’s growth is not driven by the hormones estrogen and progesterone, nor by the HER2 protein. As a result, this cancer does not react to hormone therapy or medications that target the HER2 protein receptor. Other medications, however, are used to successfully treat the breast cancer.

Consider cancer cells to be like a house. The front door may be equipped with three types of locks, referred to as receptors: estrogen, progesterone, and HER2. There are a few keys that doctors can use to help eliminate cancer cells if your cancer has any of these three locks. These keys include hormone treatment and other medications, which can be used to assist destroy the cancer cells.

However, if you have triple-negative breast cancer, this means that none of the three locks are present in your tumor. As a result, doctors have fewer therapy options available to them. Though, chemotherapy is still a viable treatment option.

This cancers account for around 10-20 percent of all breast cancers. Doctors and researchers are extremely interested in discovering new treatments that can be used to treat this particular type of breast cancer. In order to determine if certain treatments can impact with the processes that enable this kind of breast cancer to grow, researchers are conducting studies.

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Hormonal treatment drugs, such as tamoxifen and aromatase inhibitors, are unlikely to help the cancer. Additionally, it is unlikely to respond to medications that affect the HER2 protein, such as Enhertu (fam-trastuzumab-deruxtecan-nxki), Herceptin (trastuzumab), Kadcyla (T-DMA or ado-trastuzumab emtansine), Nerlynx (neratinib), Perjeta (pertuzumab), or Tykerb (chemical name: lapatinib).

Because there are fewer specific treatments available to this kind of breast cancer, it is thought to be more aggressive and have a worse prognosis than other kinds of breast cancer. This cancer has been demonstrated in studies to be more likely to spread outside the breast and to relapse (return) after therapy.

It has a higher prognosis than other forms of breast cancer. In terms of appearance and growth patterns, the higher the grade, the less cancer cells resemble normal, healthy breast cells. Triple-negative breast cancer is usually grade 3 on a scale of 1 to 3.

Who is at risk of developing triple-negative breast cancer?

1. Women under the age of 40, who are African-American, or who have a BRCA1 genetic mutation are more likely to get these cancers.
2. People under the age of 50 are more likely to be diagnosed with triple-negative breast cancer. People over the age of 60 are more likely to be diagnosed with other kinds of breast cancer.
3. TNBC may be more prevalent in Hispanic women than in white and non-Hispanic white women [57-60].
4. Compared to women of other races, triple negative/basal-like tumors appear to be more common in Black, non-Hispanic Black, and African American women (particularly before menopause) [53,55-58].

If you’ve been told you have triple-negative breast cancer.

Finding out you have a kind of breast cancer that is generally more aggressive than other varieties and isn’t a good candidate for hormone receptor or HER2 protein-targeted therapy can be frustrating and frightening.

It’s crucial to remember, however, that the lack of hormone receptors and high HER2 protein are just two of the aspects that you and your doctor will examine when deciding on a treatment strategy. Your prognosis is also influenced by the cancer’s stage and grade.

It’s also crucial to keep in mind that there are treatments for this type of cancer.

Treatment

Surgery, radiation therapy, and chemotherapy are common treatment options for cancer patients.

Immunotherapy Treatment Option

Immunotherapy medications target cancer cells by harnessing the power of your body’s immune system.

Keytruda (chemical name: pembrolizumab) is an immunotherapy drug used to treat triple-negative breast cancer.

Keytruda is a drug that is used in combination with chemotherapy to treat triple-negative, PD-L1-positive breast cancer that is unresectable locally progressed or metastatic.

The term “unresectable” refers to a cancer that cannot be removed through surgery.

Keytruda is also used to treat early-stage triple-negative breast cancer with a high risk of recurrence in conjunction with chemotherapy before surgery and then on its own following surgery (the cancer coming back).

Neoadjuvant chemotherapy Treatment option

When this type of cancer is treated with chemotherapy before surgery — known as neoadjuvant chemotherapy — when there is a pathologic complete response, research has shown that disease-free survival and overall survival are improved.

Looking at the tissue removed during surgery to see if any active cancer cells are present is one approach for clinicians to measure the effectiveness of neoadjuvant treatment. A “pathologic complete response,” or pCR, occurs when there are no active cancer cells present.

The term “disease-free survival” refers to how long a person can go without their cancer reappearing. Overall survival refers to how long a person lives after a cancer diagnosis, regardless of whether or not the disease recurs.

PARP inhibitors treatment option

PARP inhibitors like Lynparza (olaparib) and Talzenna (talazoparib) have been approved for the treatment of advanced-stage HER2-negative breast cancer in persons with a BRCA1 or BRCA2 mutation.

In both healthy and malignant cells, the poly ADP-ribose polymerase (PARP) enzyme repairs DNA damage. Medicines that interfere with or suppress the PARP enzyme make it much more difficult for cancer cells with a BRCA1 or BRCA2 mutation to repair DNA damage, according to research. The cancer cells have a tougher time surviving as a result of this. In other words, a PARP inhibitor reduces the likelihood of some cancer cells surviving DNA damage.

What is the survival rate of triple-negative breast cancer?

It is estimated that 91 percent of women will survive five years after being diagnosed with locally advanced triple-negative breast cancer, which means the cancer has not progressed outside of the breast (91 percent as likely as someone without cancer to survive during the five-year period). Cancer that has spread to surrounding lymph nodes or other nearby locations has a five-year survival rate of 65 percent when it first appears. Cancer that has spread to other parts of the body, such as the bones, lungs, or liver, has a survival rate of 11 percent or lower.

Survival rates are calculated as averages based on what has occurred in the past. The outlook for cancer patients may improve as research and cancer therapy progress.

According to the SEER database, which is maintained by the National Cancer Institute, these figures do not distinguish between stages of cancer or take into consideration variables such as patient age and overall health.

Is triple-negative cancer bad?

TNBC is classified as an aggressive disease because it grows quickly, is more likely to have spread at the time of diagnosis, and is more likely to recur after therapy than other types of breast cancer. The prognosis for this type of breastcancer is not as good as it is for other types.

How long is chemo for triple-negative breast cancer?

Twelve weeks of taxol is followed by four doses of adriamycin and cytoxan in a conventional triple-negative chemo regimen. Doctors gave participants an additional chemo medication called carboplatin in the new study. According to the study, 54 percent of women who took carboplatin were successful, compared to only 40 percent of women who did not take carboplatin. However, because to carboplatin’s high toxicity, several women were unable to take it and had to end their chemotherapy treatment early.

Is TNBC a death sentence?

TNBC does not constitute a death sentence! Patients should be informed that there are effective treatments for this condition and that they have a chance of surviving. Make a point of mentioning that TNBC is highly responsive to chemotherapy and that a large number of clinical trials are possible if normal treatment becomes unsuccessful.

Can triple-negative breast cancer be cured?

Dr. Jacoub believes that triple-negative breast cancer is treatable if it is discovered during the first three stages (1–3) of the disease. He uses every tool available to him to treat stages 1–3 cancer in order to completely eradicate and kill it.

But the capacity to treat triple-negative breastcancer is hampered by the presence of recurrence or metastasis beyond the lymph nodes of the patient. Triple-negative breast cancer is the type of breast cancer that is most likely to recur after treatment.

Over a 5-year period, the prognosis for persons with locally advanced triple-negative breastcancer is favorable. Approximately 91 percent of persons will make it to the 5-year milestone in their lives.

Those who have cancer that has progressed to local tissue or lymph nodes have a 5-year survival rate of only 65 percent. Upon spreading to other organs or tissues, the mortality rate drops to 12 percent from the initial figure.

These figures are based on data collected from patients who have previously received treatment. Newer approaches have altered the picture, which is expected to continue to vary as new therapies become available in the future.

Dr. Nan has anecdotally observed a subset of patients who have responded to immunotherapy treatment for a period of more than five years.

“Perhaps if his practice follows these patients for a long enough period of time, some of them may still be alive after more than 10 or 15 years, we will be able to declare their cancer healed,” he speculated. “In the future, we may be able to cure stage 4 cancer with immunotherapies that have been created or that are newer.”

Dr. Jacoub acknowledged that emerging treatments are altering the outlook for the future. He further stated that, while some patients experience a diminished quality of life while having therapy, others might maintain a high level of well-being throughout the process.

Is triple negative hereditary?

Researchers from the University of Southampton and colleagues from around the world tested DNA samples donated by 1824 women with triple negative breast cancer for mutations in 17 genes that have been linked to breast cancer in a study that was partially funded by Breast Cancer Campaign in order to learn more about the genetics of triple negative breastcancer. This is the broadest analysis on breast cancer gene mutations in triple negative breast cancer that has been conducted to date.

The findings, which were published revealed that 14.5 percent (167) of the triple negative patients had genetic abnormalities that were passed down via their families. The mutations were detected in 14 of the 17 genes under investigation, with the BRCA1 (155 mutations found) and BRCA2 (49 mutations found) genes exhibiting the highest frequency of alterations. A genetic mutation also increased the likelihood of being detected at a younger age, with the average age at diagnosis being 45 years old, compared to 52 for women who did not have mutations.

In addition, many of the women who had a genetic mutation did not have a family history of breast or ovarian cancer. This was especially true for women who had a mutation in a gene other than the BRCA genes.

How long can you live with metastatic TNBC?

TNBC has been demonstrated to have a bad prognosis in the majority of cases. Death rates are highest among all subtypes of breastcancer within the first 3-5 years of diagnosis, despite the fact that late relapses are less common. TNBC is a highly diverse malignancy, and the prognosis for each individual patient can be extremely variable. TNBC that has spread throughout the body is generally regarded as incurable. Patients with metastatic disease had a median survival duration of approximately 9 months, compared to a survival period of 20 months for patients with other subtypes of breast cancer. Patient’s with metastatic TNBC have a median survival period of approximately 13 months on average.

While new targeted medicines are being developed for breast cancer, there are presently no effective targeted therapies available for individuals with triple-negative breast cancer (TNBC). As an additional point of interest, there are only a few published studies in the literature that detail long-term full remissions in patients with metastatic TNBC.