There has been some fantastic news released by the FDA. With Phase three trials showing positive findings the FDA has approved the first immunotherapy drug utilized in combination with chemotherapy. This new treatment brings an alternative option for triple negative breast cancer patients.
Triple negative breast cancer occurs in 10-20% of the diagnosed cases of breast cancer. This is a diagnosis that is seen more in younger women, African-Americans, Hispanics, and women with a positive BRCA1 gene mutation.
A triple negative breast cancer diagnosis means that the tumor does not have receptors for estrogen, progesterone, or the HER-2/neu gene. Hence, triple negative.
Although this may initially sound like a good thing, it limits the types of treatment that can be used. Treatments like hormone therapy that target estrogen and progesterone, such as Tamoxifen, do not work for triple negative breast cancer. And targeted therapy that works on breast cancer with the protein HER-2 (like Herceptin) isn’t effective for triple negative breast cancer.
Chemotherapy is the treatment of choice for triple negative breast cancer.
Because triple negative breast cancer can be an aggressive form of breast cancer, and because a number of treatments are not an option, research has looked to find alternatives treatments.
A Study of 902 women in 41 different countries reviewed treatment options for advanced triple negative breast cancer that could not be removed with surgery.
All women received chemotherapy but some received an immunotherapy drug that has been approved to treat bladder and non-small cell lung cancers.
The overall results show a longer time before tumor growth and better survival rates for patients treated with the addition of immunotherapy, particularly for those patients who tested positive for the PD-L1 protein. This is the protein blocked by the immunotherapy drug.
The results are remarkable in having an alternative option for triple negative breast cancer. However, the survival rates for patients with metastatic and non surgically treatable triple negative breast cancer are not good. More work, more research, and better odds are hopefully soon to come.
Peter Schmid, M.D., Ph.D., Sylvia Adams, M.D., et al. Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer, NEJM, Oct, 20, 2018.