What are the latest treatments on triple negative breast cancer?

Chemotherapy: Triple negative implies the absence of estrogen and Progesterone receptors, as well as the absence of overexpression of the her-2 gene. Because of this, endocrine manipulation (tamoxifen, arimidex, etc. Doesn't work, nor does herceptin (trastuzumab). In addition to surgery (and sometimes radiotherapy), most triple negative patients receive combination chemotherapy.

Surgery, chemo: Triple negative breast cancer accounts for approx. 15% of all breast cancer, but up to 25 or 30% in young african-american women. It is a more aggressive cancer type and also more difficult to treat because of the lack of options (no hormonal therapy or Herceptin (trastuzumab) or lapatinib). Therefore, the main treatments are surgery and chemotherapy plus/minus radiation.

Treatments: Latest treatments are few and far between, but much research is being done and a patient could look into the new investigative trials especially if their tnbc has spread.Right now, we need to get the word out about the 15% of women who get this type of breast cancer. It is aggressive even at the earliest stages. It affects younger women-mammos/ultrasounds often look "benign" in the early stages. Bx.

Neo chemo: Local regional therapies (surg & rad) are the same for triple neg. Most all triple neg will get chemo. Some are very responsive which suggests a better prognosis. Neoadjuvant chemo identifies these (pcr). Current guidelines recommend brca testing for triple neg <age60. Parp inhibitors may have a role in triple neg +/- brca mutation.

PARP inhibitors: The most exciting new drugs for triple negative breast cancers are called parp inhibitors. These are very effective for patients who have a brca mutation as a cause of their breast cancer. Platinum drugs (carboplatin, cisplatin) have also been shown to be very effective in triple negative tumors. Research in this area is thriving, so more treatments are on the horizon!

TNBC: Tnbc are considered aggressive tumors and thereby need aggressive management. They are driven by brca mutation in lot of pts. Adjuvant chemo using doublets is recommended and incorporating platinum salts can be beneficial. Parp inhibitors look promising but data is missing to support a broader use. Careful planning needs to take place in adjuvant setting regd surgery and radiation in these pts.