Immunotherapy and anti-androgen therapy are among the newest approaches in the fight against triple negative breast cancer (TNBC). TNBC patients have traditionally been told that they have a more aggressive type of cancer and few treatment options. That’s because TNBC, diagnosed in about 15-20% of breast cancers, is characterized by a lack of estrogen, progesterone, and HER2 expression. The result is that the tumors do not respond to standard endocrine therapy or HER2 targeted treatment. Fortunately, the research landscape is changing and offering new options.
Due to gene expression profiling and a better understanding of how tumors differ, TNBC is no longer viewed as one subtype of breast cancer. This is leading to the discovery of new targets and novel therapeutic approaches for those enrolled in triple negative breast cancer trials.
If you’re a TNBC patient looking to identify all your treatment options, there are three steps: know your exact diagnosis, be aware of the latest treatment options, and take charge of your medical records to ensure that you’re being correctly matched to the triple negative breast cancer trials available to you.
1. Know your diagnosis
The stage of a cancer and whether it’s metastasized and the type and activity of cancer cells in a tumor are the primary factors that affect a cancer prognosis. Researchers have identified six main subtypes of TNBC. According to one dataset report, these subtypes show that there is a “wide range of survival over 20 years from initial detection and that each subtype is inherently heterogeneous and driven by different oncogenic alterations within each subtype.”
According to a review by Breastcancer.org, some TNBC subtypes may have better survival rates than hormone-receptor-positive breast cancer. To best understand your diagnosis, ask your doctor about TNBC subtypes and whether gene expression profiling has been done as part of your pathology report and how that may impact your treatment.
The gene expression profiling of tumor cells that allows for subtyping differs from what we commonly refer to as genetic testing, also known as germline testing, which tests for hereditary factors, such as BRCA1 or BRCA2 mutations, in healthy cells. Approximately 5-10% of breast cancers are believed to be hereditary. The most well-known genes that can mutate and increase the risk of breast and ovarian cancer are BRCA1, BRCA2, and PALB2. A mutation in BRCA1 increases the risk of developing TNBC. Researchers are also identifying other genes that may be linked to the development of TNBC.
There is debate about which breast cancer patients should receive germline testing. The American Society of Breast Surgeons has come out in favor of expanding testing in recent guidelines. This differs from the current National Comprehensive Cancer Network (NCCN) guidelines. Organizations like Breastcancer.org argue that the cost of testing has come down and that patients should have the option once they’ve discussed the issue with their oncologist.
2. Follow medical advances
Research shows that tumors become more complex and resistant as they progress, so targeting TNBC tumors in a more personalized way with novel therapies early on may result in better outcomes.
With thousands of investigations underway, it’s impossible for patients to follow all the medical advances. Fortunately, many organizations offer news and summaries. The Breast Cancer Research Foundation has outlined newer approaches and provides coverage of the San Antonio Breast Cancer Symposium, which is the largest scientific conference dedicated to breast cancer.
The Triple Negative Breast Cancer foundation pays close attention to medical updates regarding the treatment of TNBC. Breastcancer.org also has treatment updates, such as an overview of the immune targeted therapy, Trodelvy. When you hear about this kind of novel treatment approach, it’s good to run the name through an FDA search to seek out an objective view with additional background information. Cancer Connect, an online network, offers treatment updates and support. That said, you should discuss all final decisions with your oncologist.
Though a cancer that has metastasized has a worse prognosis, metastatic disease is treatable. Ricki Fairley, a metastatic TNBC survivor and founder of Touch, The Black Breast Cancer Alliance, encourages patients to stay positive and keep informed. Many patient experiences show how different TNBC can be when it comes to treatments and survival.
3. Take control of your medical records now
A search for triple negative breast cancer trials can be daunting. ClinicalTrials.gov brings up more than 800 studies related to TNBC. Even with the help of matching tools, the process can be overwhelming. The criteria for a trial require specific tumor types, stages, and grades, along with other basic information, such as family history. Submitting your full medical record is critical. Patient portals typically don’t contain provider notes or give patients a comprehensive look at their labs, medical history, or vitals. Some patients are excluded from clinical trials if complications or delays occur.
To ensure a seamless process, many patients are opting for Ciitizen, a clinical trial matching service that alleviates the stress of compiling medical records and automatically matches a patient with available trial options.
Ciitizen is a free service that helps patients get more out of their health records. Our platform enables patients to find better treatment options and gives them the opportunity to advance the research for cures. Ready to control all of your medical records in one place? Sign up today in less than 5 minutes!