Clifford A. Hudis, MD
Clifford A. Hudis, MD, ASCO president, chief, Breast Cancer Medicine Service, attending physician, Memorial Sloan-Kettering Cancer Center, discusses the challenges and recent advancements of treating patients with triple-negative breast cancer (TNBC).
Although TNBC has always been understood and recognized, it continues to be a focal point of research and represents one of the remaining prominent challenges in breast cancer, Hudis says. While all types and stages breast cancer has challenges, physicians and researchers have failed to make large strides with targeted therapies in TNBC compared to hormone receptor-positive disease and human epidermal growth factor receptor-positive disease.
Hudis says researchers struggle with TNBC because they are unsure if it is a single entity or if it is another collection of subtypes of breast cancer that might be amenable to targeting. Drugs must also be developed to address the totality of TNBC or at least change outcomes for a number of identifiable subsets.
But advancements are being made in the field. Hudis says there is a focus on the small proportion of patients with TNBC that express the androgen receptor (AR). AR-positive TNBC may be a subtype of the disease where researchers can focus on one type of therapy -- a non-toxic hormone treatment.
If researchers can detect the presence of AR in a triple-negative tumor using a conventional Dako IHC stain, bicalutamide can be used to give these patients a 20% chance of long-term disease stabilization, Hudis says.
Although this treatment is only temporary and not a cure, Hudis says, it is an important advance in TNBC.