Triple Negative breast Cancer

10 - 20% of breast cancers do not express the oestrogen, progesterone or HER2 receptors and are consequently referred to as triple negative tumours. The majority have a basal phenotype.  As cell receptors are absent, endocrine therapy with Tamoxifen or Aromatase inhibitors will not be effective. Neither will Herceptin. This means that the medical oncologist must plan treatment using conventional chemotherapy drugs.

Common drugs that are used include doxorubicin (Adriamycin) Epirubicin and Cyclophosphamide. Fluorouracil is often added to this combination (FEC) A Taxane Paclitaxel (Taxol) or  docetaxol (Taxotere) may be prescribed  after  FEC.

Initial treatment will usually consist of surgery (breast conserving partial mastectomy or mastectomy) depending on size and multifocal nature of tumour. Chemotherapy will start approximately  2 -3 weeks after surgery and usually lasts for 4 - 6 months . This may be followed by radiotherapy.

There is a lot of research interest in newer drugs that may be effective in triple negative tumours

PARP inhibitors

(Poly ADP ribose polymerase)In normal cells  PARP repairs damaged DNA. Overactivity of PARP in cancer cells may increase cancer cell growth. PARP inhibitors can prevent cancer cells repairing themselves. Clinical trials are underway to  assess efficacy in Triple negative cancers.

Antiangiogenic agents

Drugs that inhibit blood vessel growth to the cancer will restrict its growth. They act by blocking the vascular endothelial growth factor receptor (VEGFR inhibitors)

DNA damaging drugs

Platinum based medicines that interfere with  DNA building blocks.

SORBET Trial Can Tamoxifen work for triple negative breast cancer

Because of the unique features of triple negative tumours and limited efficacy of existing treatments special interest groups have evolved to provide support and up to date information to patients and their families about new developments and treatment trials.

Triple Negative Breast Cancer

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