Triple Negative Breast Cancer Clinical Trial
Ongoing clinical trial tried to investigate effectiveness and safety of different possible treatment for future use and also has several clinical trials in the pipeline. The patient can also enroll their name in these trials to get novel therapies and also assist in research by providing the data to the research team. The different research aim is different, some are investigating new therapies to treat the patient, whereas some drugs may use in preventive therapy. Name registration for a clinical trial is the first step to enrolling name to the research3,4.
References
New Treatment Approach For Rare Type Of Triple Negative Breast Cancer Identified
In a new study, published in journal Clinical Cancer Research, researchers at the charitys centre at The Institute of Cancer Research, London, demonstrated in cell-lines and in mice that palbociclib could be used effectively to treat certain triple negative breast cancers opening the door to an exciting new use for this first-in-class drug, which now needs to be trialled in patients.
Triple negative actually represents a diverse group of subtypes of the disease that lack the three molecules typically used to classify breast cancers: the oestrogen receptor , progesterone receptor , and human epidermal growth factor receptor 2 . TNBCs tend to exhibit aggressive behaviour and are more likely to spread to another part of the body, becoming incurable and they are more likely to be diagnosed in black women than Caucasian women.
A subset of these TNBCs are known to have cells which produce androgen receptors and are therefore known as Luminal Androgen Receptor breast cancers.
It is estimated that around 1,000 women each year in the UK are diagnosed with LAR triple negative breast cancer which accounts for around 2% of all breast cancers. This form of breast cancer cannot be treated with targeted drugs commonly used to treat other types, such as tamoxifen and aromatase inhibitors or Herceptin .
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, which funded the study, said:
Brca1 Inherited Gene Mutations And Tnbc
Most breast cancers related to a BRCA1 inherited gene mutation are both triple negative and basal-like .
TNBC may also be related to a BRCA2 inherited gene mutation .
The National Comprehensive Cancer Network recommends people diagnosed with TNBC at age 60 or younger get genetic testing .
Learn more about genetic testing.
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A Note About Statistics
Survival rates are statistics, and as such tend to tell us how the âaverageâ person will do with an âaverageâ triple-negative breast cancer but people and tumors arenât statistics. Some people will do better and some people will do worse.
Very importantly, statistics are usually several years old. In order to calculate five-year survival rates, a person would have to have been diagnosed at least five years prior. And still there is lag time. The treatment of triple-negative breast cancer is changing, and new drugs have been approved.
Mercks Keytruda Plus Chemotherapy Reduced Risk Of Death By 27% Versus Chemotherapy As First
First Anti-PD-1 Therapy in Combination With Chemotherapy to Demonstrate Statistically Significant Overall Survival for These Patients
Data From Phase 3 KEYNOTE-355 Trial Presented at ESMO Congress 2021
KENILWORTH, N.J.â-Merck , known as MSD outside the United States and Canada, today announced the final overall survival results from the pivotal Phase 3 KEYNOTE-355 trial investigating KEYTRUDA, Mercks anti-PD-1 therapy, in combination with chemotherapy for the first-line treatment of patients with metastatic triple-negative breast cancer . KEYTRUDA is the first anti-PD-1 therapy in combination with chemotherapy to demonstrate a statistically significant and clinically meaningful improvement in OS for these patients.
In this study, KEYTRUDA plus chemotherapy reduced the risk of death by 27% in patients with mTNBC whose tumors expressed PD-L1 , as compared to chemotherapy alone. There was an increase of 6.9 months in median OS with KEYTRUDA plus chemotherapy compared to chemotherapy alone . Although the trial was not powered to compare efficacy between treatment groups by different chemotherapy regimens, the increase in OS was observed for KEYTRUDA plus chemotherapy across the three chemotherapy choices. These data were presented today in an oral presentation at the European Society for Medical Oncology Congress 2021 .
About KEYNOTE-355
About KEYTRUDA® Injection, 100 mg
Selected KEYTRUDA® Indications in the U.S.
Melanoma
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Role Of Platinum Agents
TNBC is often associated with a deficiency in BRCA-driven DNA repair mechanisms, leading to a higher sensibility to interstrand cross-linking agents damaging the DNA, such as platinum agents .
Contrary to data obtained in the metastatic setting, the carboplatin effect was independent of gBRCA status. Patients with gBRCAm had in general a higher pCR rate compared to wild type ones, but the increase in pCR with the addition of carboplatin was more prominent in the wild type cohort . One explanation of the different results could be the single versus combination therapy or the treatment setting.
Results of meta-analyses are consistent . Even though only a few small studies assessed the role of cisplatin , it seems to be as effective as carboplatin in increasing the pCR rate, but with a different safety profile . A head-to-head study of 4 cycles of weekly carboplatin or cisplatin and paclitaxel showed similar pCR rates and outcomes for the 2 compounds. No significant differences were seen in terms of AE .
Many new trials have incorporated carboplatin as part of the standard regimen. Its use is recommended irrespectively of the BRCA status.
What Is The Prognosis For Triple
A good treatment result depends on several factors. Chemotherapy is what can really make a difference in the outcome. The size of the invasive part of the tumor, and the number of involved lymph nodes can also greatly influence your prognosis, Sun says, but adds that if the cancer has spread , the prognosis is less certain.
There is hope, even with this serious diagnosis, and staying optimistic is essential. It can be stressful and scary to go through chemo, but positive thinking can make a difference. You have to believe that its doing you good, and for most people, it does.
Breast Cancer Treatment at Johns Hopkins
The breast cancer program at Johns Hopkins is made up of a diverse group of nationally-recognized specialists in breast cancer research and treatment.
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The Prognosis For Patients With Triple
Prognosis refers to the likely outcome of treatment for patients with triple-negative breast cancer. Unlike other types of breast cancer that have a well-proven set of treatments, triple-negative breast cancer is still in the process of being researched for a more standardized treatment plan. Because of this, several treatments may be needed to find one that is effective. Studies have shown that triple-negative breast cancer is more likely to have metastasized , have a higher grade, and are more likely to recur after treatment.
Survival Rate For Patients With Triple
Triple-negative breast cancer is considered aggressive, or fast-growing, but it is treatable. Survival depends on factors such as how advanced the cancer was at diagnosis, your overall health, and your response to treatment.
When assessing survival, researchers use a 5-year marker to make predictions about if cancer will reoccur.
According to the American Cancer Society, if any type of breast cancer is found to be stage 1, the 5-year survival rate is nearly 100%. Stage 2 breast cancer survival is about 93%, stage 3 is 72%, and metastasized or grade 4 breast cancer has about a 22% chance of survival. Keep in mind most triple-negative breast cancers are stage 3 when found.
Its important to note that the survival rates may be higher than this data suggests because new treatments are becoming available through clinical research.
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Mechanisms Of Breast Cancer Metastasis
No one really knows what factors will make a certain patient more or less susceptible to breast cancer metastasis.
There is growing awareness that part of that susceptibility is due to host factors. The host factors are the characteristics of the non-malignant cells and the general biological environment surrounding the malignant breast tumor.
Sometimes the host factors are referred to as the pre-metastatic niche and it is thought that bone-marrow-derived progenitor cells may directly influence the dissemination of malignant cells to distant areas.
Non-neoplastichost cells within the tumor may also play a key role in the regulation of breast cancer metastasis.
Myth #: People With Metastatic Breast Cancer Look Sick And Lose Their Hair
You dont look sick. You look so well. Why do you still have your hair? Are you sure you have cancer? These are comments that people with MBC report hearing. But there are many treatment options besides chemotherapy, and people often appear well while taking them.
As NancyHB comments: Id much rather be a poster child for how sometimes we can live with, rather than die from, MBC at least for a while. Instead, I find myself defending against people who are increasingly becoming impatient with my lack of cancer-patient appearance. Im grateful for this time of feeling good, and theyre harshing my buzz.
Some people with MBC report that they actually look better than they feel while in treatment. So they sometimes have to let family and friends know that even though they appear fine, they dont feel well.
Shetland Pony notes: If she looks good, she is good. Nope. Many of us suffer from the invisible disability of fatigue. I would venture to say every available treatment causes us some level of fatigue. We struggle to keep up. It may look like we are doing the bare minimum when we are really giving it our all.
JoE777 of Texas adds: The new normals advertised about therapies on TV are deceiving about the side effects. They talk about side effects while women are skipping through life. not looking to show the harsh side effects but think there is something wrong with me that my life is not like that.
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Basal Cell Breast Cancer
Basal cell breast cancer is a type of breast cancer with a clear pattern of changes in proteins in the cells.
Cancer doctors recognise basal cell breast cancer when they examine the cancer cells under a microscope. It is often linked with triple negative breast cancer.
Basal cell breast cancers are usually triple negative. And most triple negative breast cancers are basal cell cancers. They are similar types of breast cancer, but not exactly the same.
See also
The symptoms of triple negative breast cancer are the same as for other breast cancer types.
See also
Survival Rates For Stage Iv Breast Cancer
Stage of breast cancer at diagnosis is one of the most important prognostic factors. Above is a bar chart from the National Cancer Institute statistics for 2012. As we can see, the 5-year survival rate for women diagnosed with Stage IV breast cancer was 22%.
Remember, these figures are still quite dated as it takes 5 years to determine survival rates and treatment is improving all the time.
A recent study found that 37% of women survived for three years after a Stage IV breast cancer diagnosis, although some women do survive longer.
However, although the 5-year survival rates are much higher for earlier stages of breast cancer at diagnosis, there is no predicting which cases will progress to metastatic breast cancer in the future.
Although it is important to be realistic regarding the survival of metastatic breast cancer, each individual situation is unique and ultimately, statistics are meaningless.
There is a small subcategory of people with Stage IV breast cancer who beat the odds and live for years. However, it is difficult to predict who will fall into this group.
All that is known is that people in this group have secondary spread to the bones. Furthermore, cancer is often estrogen positive and responds to hormone treatments.
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This Is My Story With Stage 3 Triple Negative Breast Cancer To Date
My story begins like this:
- World Masters October, 2009 Sydney I competed in the 50-54 age group events in both swimming & athletics where I obtained top ten finishes in every event, my best result being 4th in the Javelin throw.
The key events are:
- All the while having my treatment I maintained a high level of fitness running, swimming & gym despite being very sick hoping to still be able to compete at World Masters in Italy, August 2013.
It ends like this:
- May 2013 Admitted to hospital with heart complications . Given heart medication.
However, I am determined to be on that starting line for the Pan Pacific Masters Games in November competing in athletics 2 km steeplechase, shot put, discus, javelin & the weight pentathlon & swimming 50, 100, 200 & 400 backstroke & 200, 400 freestyle & the 1.5 km open water.
I also have something called MGUS in my blood, which is an early marker for multiple myeloma, which is a blood cancer.
Sometimes we are dealt some unfortunate cards in life but its nothing that we can controllife is there to be lived no matter what!
Triple Negative Breast Cancer
One of the most aggressive types of Breast Cancer known in oncology is the Triple Negative type, which means that the surface receptors of the Cancer Cells are negative for the Hormone Receptors as well to the Epidermal Growth Factor . The main features of this type of breast cancer is that it affects younger women , usually present at an advanced or sometimes terminal stages, but the most important fact it that, they usually respond poorly to chemotherapy and this is translated into a poor survival figures for patients with this disease that come down to a median survival of 1 year for patients with stage 4 disease, and unfortunately, nearly all patients with stage 4 disease die from breast cancer.
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How Common Is Tnbc
About 15-20 percent of all breast cancers are TNBC or basal-like tumors .
TNBC tends to occur more often in :
- Younger women
- People with an BRCA1 inherited gene mutation
- Black, non-Hispanic Black and African American women
TNBC may also be more common among Hispanic women compared to non-Hispanic white women .
Why This Research Is A Revolution In The Management Of Triple Negative Breast Cancer
This research is revolutional as it explained to a large extent why patients with Triple Negative Breast Cancer fail the current standard chemotherapy which is based mainly on three chemotherapy types: Taxol , Adriamycin , and the Cyclophosphamide . Patients either receive the 3 agents together, a regimen called TAC for 6 cycles every three weeks, or as AC for 4-6 cycles then a weekly Taxol for 12 cycles . What are the implications of receiving these aggressive chemotherapies without a success or control of cancer?The major drawbacks of using these chemotherapy regimens are simply treating this type of resistant cancer with low effective therapies, suppressing the immune system with this powerful medications and immune suppressors with a very low or even no gain, not to mention the huge medical and health costs that result from buying the chemotherapies to recruiting the staff who administer these chemotherapies, doing a long list of blood works and most important is hospital admissions for patients who develop very low immunity and have to be admitted for treating febrile neutropenia or severe thrombocytopenia that exhaust the countrys financial and economic resources with no great success in disease management.
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How Is Triple Negative Breast Cancer Different From Other Types Of Breast Cancer
Triple negative breast cancer is different from other types of breast cancer because it does not have any of the three receptors commonly found on breast cancer cells:
If you have triple negative breast cancer, you may notice that your treatment is slightly different from that offered to other people with breast cancer.
People with oestrogen and/or progesterone receptor positive breast cancer will usually take tamoxifen or an aromatase inhibitor as part of their treatment. People with HER2 positive breast cancer will usually take a drug called Herceptin. These drugs are not effective against triple negative breast cancer.
How Is Triple Negative Breast Cancer Diagnosed
The first step might be a mammogram to evaluate a suspicious mass or lump in your breast. Based on what they learn, healthcare providers might perform a biopsy to remove breast tissue. Then they examine the tissues cells to determine the cancer subtype. Identifying the cancer subtype is part of the staging process, which is when providers decide how to treat your cancer.
Sometimes providers use the following tests before treatment to check on your tumors size and whether it has spread, or after treatment to monitor response to treatment:
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Fda Approves Keytruda For Early
- Tags:HER2/neu Negative Cancer, Progesterone-Receptor Negative, Estrogen-Receptor Negative, Triple Negative Breast Cancer, Early-stage: Stage IIIA, Early-stage: Stage IIB, Early-stage: Stage IIA, Early-stage: Stage IB, Early-stage: Stage IA, Tumor 6 cm or Larger, Tumor Between 5 cm and 5.9 cm, Tumor Between 4 cm and 4.9 cm, Tumor Between 3 cm and 3.9 cm, Tumor Between 2 cm and 2.9 cm, Tumor Between 1 cm and 1.9 cm, Keytruda , Preparing for/Undergoing Immunotherapy, Immunotherapy After Surgery , and Immunotherapy Before Surgery
On July 26, 2021, the U.S. Food and Drug Administration approved the immunotherapy medicine Keytruda plus chemotherapy before surgery, followed by Keytruda alone after surgery to treat early-stage triple-negative breast cancer with a high risk of recurrence .
Doctors call treatments given before surgery neoadjuvant treatments and treatments given after surgery adjuvant treatments.
Early-stage triple-negative breast cancer is considered to have a high risk of recurrence if:
- the tumor is between 1 and 2 cm in size and the cancer has spread to the lymph nodes
- the tumor is larger than 2 cm, regardless of whether the cancer has spread to the lymph nodes or not
- progesterone-receptor-negative
- HER2-negative