New way to predict response to chemo in triple-negative breast cancer

Researchers from University Hospitals (UH) Case Medical Center's Seidman Cancer Center will present findings from a study that found the presence of tumor-infiltrating lymphocytes, a type of white blood cell, ahead of treatment may help predict response to platinum-based chemotherapy in women with triple-negative breast cancer. The data are being presented at the 50th American Society for Clinical Oncology (ASCO) Annual Meeting in Chicago.

"Triple-negative breast cancers tend to be more aggressive compared to other types of breast cancers, and being able to predict response to therapy could greatly impact treatment decisions and patient outcomes," says study author Shaveta Vinayak, MD, oncologist at UH Case Medical Center and Assistant Professor at Case Western Reserve University School of Medicine. "Our research shows that the presence of lymphocytes before administering chemotherapy could predict a positive response to platinum-based therapy."

Triple negative breast cancers are those that do not have estrogen or progesterone receptors, and do not have an excess of the HER2 protein on the cancer cell surfaces. This makes it more difficult to treat because the hormone-blocking or the HER2-targeting treatments do not work. Triple negative breast cancers tend to occur more often in younger women and in African-American women.

Platinum-based therapies are being tested in clinical trials for triple-negative breast cancer, and evaluation of tumor-infiltrating lymphocytes is an important factor in determining response to this treatment. For oncologists, this could provide a new tool to individualize treatment for these women.

Researchers from various institutions in the Eastern Cooperative Oncology Group, one of the largest clinical cancer research organizations in the United States that conducts clinical trials in all types of adult cancers, contributed to this analysis. Funding for this study was provided by Breast Cancer Research Foundation, ASCO Conquer Cancer Foundation, Triple-Negative Breast Cancer Foundation, Myriad Genetics, and National Institutes of Health (Stanford CTSA).

True or False? There are no good treatments for TNBC.

FALSE! There ARE good treatments for TNBC-it's just that two of the most common treatments for most types of breast cancer don't work for TNBC patients.

To be more specific, TNBC cannot be treated with the medications known as tamoxifen, aromatase inhibitors, or trastuzumab. The reason for this is because TNBC does not have the targets known as estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (Her2) needed for these drugs to work. It is the lack of these targets that lead to the name “triple-negative.”

However, all of the other available therapies for breast cancer-surgery, radiation, and chemotherapy-can do a good job of treating TNBC. In fact, a lot of research has found that the early response to chemotherapy is often better in patients with TNBC than in patients with other types of breast cancer.