Targeting Resistance in Triple Negative Breast Cancer

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Targeting Resistance in Triple Negative Breast Cancer

Dr. Helen Piwnica-Worms

One in six women with breast cancer, and one in three African American women with breast cancer, have triple negative breast cancer (TNBC). TNBC is an aggressive subtype of breast cancer that lacks the receptors typically targeted in the other subtypes therefore precluding the use of some of our most effective and targeted breast cancer treatments for these patients.

Systemic neoadjuvant chemotherapy (NACT) is the current standard of care for patients with early-stage TNBC. Recently, immunotherapy has also been approved for treating TNBC in the neoadjuvant setting, and PARP inhibitors (PARPi) are increasingly used for TNBC patients with germline mutations in BRCA1 or BRCA2, though still in the adjuvant setting. Unfortunately, up to 70% of TNBC patients have significant residual disease once NACT is completed, and this is associated with a high risk of developing recurrence within two to three years of surgical resection. Thus, identifying ways to eradicate therapy resistant TNBC remains an unmet clinical need.

Through this study, we aim to eradicate TNBC cases that fail to be eliminated by these standard courses of care; or, in other words, those that are treatment refractory. Specifically, our study will help us identify key biomarkers driving this resistance, which in turn, would allow us to identify effective targeted therapies for patients with treatment refractory TNBC.  Since TNBC accounts for 15-20% of breast cancer cases in the United States and is highly aggressive, finding a solution to this clinical unmet need has never been more important.