What fuels triple-negative breast cancer?


Question from Marilyn in Miami: If ER/PR/HER2 fuels breast cancer, what is fueling triple-negative breast cancer and when will targeted therapies be available?
Answers - Beth Baughman DuPree, M.D., F.A.C.S. There are some trials that are attempting to develop regimens for triple-negative cancers. They're trying to determine whether antiangiogenic agents can specifically target the triple-negative cancers better than the standard chemotherapy. That would be the drug Avastin (chemical name: bevacizumab). There are other emerging targeted therapies that are working on trying to incorporate aspects of increasing cellular proliferative pathways and cellular repair pathways. These are looking at growth factor receptors such as EGFR (epithelial growth factor receptor) but most of these studies are Phase I evaluations and not quite ready for prime time yet. In order to develop a targeted therapy, we have to know exactly what pathway of cell division and cancer proliferation we're trying to stop. So there is ongoing research but most of those studies are within Phase I and Phase II.
George Sledge, M.D. An area that is of real interest now in the laboratory and the clinic are new drugs called PARP inhibitors. These are drugs that interfere with DNA repair in breast cancer and there is laboratory evidence to suggest that particularly for BRCA1 and BRCA2 tumors, these PARP inhibitors may turn out to be active agents for the treatment of these cancers since these cancers tend to have altered and impaired DNA repair. There has already been Phase I data in ovarian cancers presented at this year's ASCO meeting in a fairly heavily pretreated population of BRCA1 and 2 with ovarian cancer, suggesting significant activity with this agent. There are now trials going on in BRCA1 and BRCA2 mutation carriers in breast cancer. What is particularly interesting about this is that the great majority of BRCA1 mutation carriers have triple-negative breast cancers. Indeed, there is certainly a suggestion from some of the laboratory studies that other triple-negative breast cancers may at least share some of these problems with DNA repair that make the mutation carriers more sensitive. So this is an exciting and emerging area of research for which we should keep our eyes peeled over the next few years.

On Wednesday, July 16, 2008 our Ask-the-Expert Online Conference was called Triple-Negative Breast CancerGeorge Sledge, M.D. and Beth Baughman DuPree, M.D., F.A.C.S. answered your questions about triple-negative breast cancer and its treatment.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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