RE: Peer Group Average - £ 52.1m19 Sep 2021 20:21
Triple negative are the most difficult type of breast cancers to treat. They have the highest rate of recurrence, are the most aggressive (almost always being grade 3) and disproportionately affect young people. They are not driven by hormones that other cancers are driven by, such as oestrogen and progesterone, hence the name triple negative, which refers to the three main hormone areas that usually drive breast cancers. Therefore, they are particularly difficult to treat, as usually women can be given drugs such as tamoxifen or Herceptin to block the pathways of these female hormones, to help stop the cancer dividing, but these drugs are of no use here. These cancers are also basal-like, so they don’t behave like other breast cancers, are less predictable and more difficult to find their cause and how they operate. It is a very hot area for research at the moment, as the prize is huge. As porky mentioned there are lots of new candidates and treatments for breast cancers on the whole, it is a well funded area as it affects so many people and on the whole the chances of survival are very good. This is not the case for triple negative, however. Just to put it into perspective, the prognosis for survival is poorer than all of the other types of breast cancer (my own individual projection was 55-60% chance of survival), due to the fact that triple negative tend to behave very differently from each other even, so it’s not simple to find one cause or one pathway that will stop it.
So, after the background information, on to treatment. The options are few. It’s basically an operation (mastectomy), followed by chemotherapy then radiotherapy. Then after that, nothing. Due to the aggressive nature of the cells, there is a high chance of recurrence and currently no real option past these treatments to stop it. You cross your fingers and wait for three years. Keytruda can be used in conjunction with the chemotherapy and there is also the PARP inhibitor olaparib, which we have all heard about, for BRCA1 mutated versions, so a very limited proportion of cases can be helped by this. That’s mainly it, unless it then spreads and there are a couple of things to help prolong life a little. The areas that are being looked into currently, are focused or repurposing existing drugs along a couple of different known pathways to try and target possibly 20% of all triple negative tumours (I can provide details of these for reference if anybody is interested). It’s so difficult to find a pathway, as mentioned earlier that is common to all triple negative cancers, hence it being such a hot area of research at the moment by a lot of the big pharmas. A drug was given FDA approval (Tecentriq, by Roche, I believe) and actually pulled from the market less than a month ago, as it actually adversely affected survival upon further testing.
The bottom line is that I have yet to hear about a NEW drug to treat this, until reading the RNS last week.
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