Immunotherapy and Triple Negative Breast Cancer
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/ Updated June 12th, 2023

Immunotherapy and Triple Negative Breast Cancer

Medical Source: Dr. Heather McArthur
Cedars-Sinai Medical Center
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The promise of immunotherapy in treating breast cancer has been extensively evaluated in women with metastatic triple negative breast cancer, says Dr. Heather McArthur, previously medical director of breast oncology at Cedars-Sinai Medical Center and now  clinical director of the Breast Cancer Program at Simmons Cancer Center at University of Texas Southwestern.

According to Dr. McArthur, studies suggest that giving these drugs early on in the treatment of metastatic triple negative breast cancer works better than when taken after chemotherapy. Clinical trials also suggest that for women with non-metastatic triple negative breast cancer who received immunotherapy and chemotherapy before surgery, 80 percent of these women had a “pathologically complete response” at the time of surgery meaning there were no cancer cells left in the breast. These trials led to the approval of Keytruda (pembrolizumab) for treatment of early stage triple negative breast cancer. Keytruda can be used with chemotherapy before surgery and then continued alone after surgery if you are at high risk for your breast cancer returning.

Is My Cancer Really Triple-Negative?

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You might be told you have triple-negative breast cancer, that means that your cancer is not being fueled by any of the three main types of receptors: estrogen, progesterone nor the HER2 protein. But now you could be categorized as HER2 low instead of HER2 negative.

Breast cancer cells with higher-than-normal levels of HER2 are called HER2-positive, those with low levels of HER2 are (or were) called HER2 negative. Recently, however, researchers have looked to further expand this definition to include patients that have a minimal amount of HER2 expression but do not meet the classic definition for HER2-positive tumors. This group has been called HER2 "low" and is very important as it represents almost 50% of all patients with breast cancer.

This excitement stems from the fact that HER2-low breast cancers are targetable with a recently new FDA-approved Enhertu (Fam-trastuzumab deruxtecan-nxki). It appears that Enhertu is extremely effective for appropriate patients and can greatly improve their quality of life and help them live longer.

Therefore, it is exceedingly important to discuss with your physician about your HER2 status.

 

Learn more about SurvivorNet's rigorous medical review process.

Dr. Heather McArthur is Medical Director of Breast Oncology at Cedars-Sinai Medical Center in Los Angeles. Read More

Triple Negative Breast Cancer

Because triple negative breast cancers are not fueled by any of the three main types of receptors, hormonal therapies are not an option. But there are still many treatments available including surgery, radiation, and chemotherapy.

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