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27-11-2016 | Triple-negative breast cancer | Book chapter | Article

6. Triple-Negative Breast Cancer

Author: Melinda L. Telli

Publisher: Springer International Publishing

Abstract

Breast cancer is a heterogeneous disease consisting of distinct biological subtypes and triple-negative breast cancers (TNBC) are those that lack expression of the breast cancer prognostic markers ER, PR and HER2. TNBC often follows an aggressive disease course with poorer disease-specific survival compared to other breast cancer subtypes. Recent increased understanding of the molecular mechanisms responsible for the initiation and propagation of this breast cancer subtype has been gained through gene expression profiling, the study of cancer genetics and the study of host antitumor immunity. A subset of TNBCs express the androgen receptor (AR) and trials are underway to assess the efficacy of androgen receptor antagonists in this subgroup. In addition to germline BRCA1 and BRCA2 mutation status, biomarkers of genomic instability have been developed that detect genomic “scarring” caused by accumulated DNA damage. Therapeutic strategies are currently being investigated to assess whether these germline and genetic biomarkers can identify groups of patients with TNBC with underlying DNA repair deficiency more likely to benefit from DNA repair defect targeted therapies. A role of host antitumor immunity has also been implicated in TNBC and studies are underway to assess immune checkpoint blockade and other immunotherapeutic strategies in these patients. While we currently lack targeted therapeutic strategies for patients with TNBC, the discovery of novel biomarkers and the development of selective therapies targeting these biomarkers offer tremendous promise for the future.

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Medicine Matters Oncology

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