Publication: Cancer Network, National
As part of our coverage of the 33rd Annual Miami Breast Cancer Conference, held March 10-13 in Miami Beach, Florida, we spoke with Joyce O’Shaughnessy, MD, co-director of breast cancer research at the Texas Oncology–Baylor Charles A. Sammons Cancer Center in Dallas, Texas, who presented a review of novel strategies for targeting drivers of triple-negative breast cancer (TNBC). Cancer Network: Why has treatment of TNBC proven to be so challenging? Dr. O’Shaughnessy: Because of the biology and response to treatment. The heterogeneous subtypes of TNBC are very different and we do not yet have robust diagnostic tools to differentiate these subtypes.
Cancer Network: What’s known about the genomic and gene expression–based subtypes of TNBC—and how do these shed new light on treatment strategies?
Dr. O’Shaughnessy: The answers to this question are still very much in evolution. No genomic subtyping is yet of clinical utility in choosing best therapies for TNBC patients. In general, we think of TNBCs that are highly proliferative and sensitive to DNA-damaging chemotherapy, those that are more mesenchymal and invasive and not very responsive to chemotherapy, and those that express the androgen receptor (AR).
No assays have yet been validated except for AR-IHC, which can be used in metastatic TNBC to identify patients who may benefit from AR antagonists.
Cancer Network: What are the most promising genomic and genetic targets for treating TNBC?
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