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 http://www.tnbcfoundation.org/tnbcguide.htm