Personalized Medicine in Triple-Negative Breast Cancer
Published Online: Wednesday, October 2, 2013
For High-Definition, ClickThe area of precision medicine and personalized care has gained a great deal of attention in recent years, explains Adam M. Brufsky, MD, PhD. However, at this point, personalized treatment approaches for patients with triple-negative breast cancer (TNBC) remains an unmet need.
To help address this, assays such as the homologous recombination deficiency (HRD) score are currently under investigation, suggests Joyce A. O'Shaughnessy, MD. The HRD score is based on loss of heterozygosity (LOH) and may predict pathologic response following neoadjuvant platinum-based therapy in triple-negative and BRCA1/2 mutation-associated breast cancer, O'Shaughnessy notes.
Alterations in the BRCA1/ 2 genes represent a known actionable mutation in TNBC, points out Sara Hurvitz, MD. To capitalize on these mutations, clinical trials are exploring PARP inhibition. One such agent, BMN 673, demonstrated promising results in early phase clinical trials, Hurvitz notes.
Outside of molecularly targeted agents, research is examining the continued use of cytotoxics in TNBC, explains Hope S. Rugo, MD. In the randomized phase III CALGB 40502 trial, weekly paclitaxel was compared to weekly high-dose nab-paclitaxel or ixabepilone with or without bevacizumab as first-line therapy for metastatic breast cancer with subset analysis specifically in TNBC. Results from this subset analysis sparked further ongoing research into nab-paclitaxel specifically in patients with TNBC, Rugo suggests.
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Sara Hurvitz, MDAssistant Professor & Director,
Hematology/Oncology Breast Cancer Program, UCLA's Jonsson Comprehensive Cancer Center, Los Angeles, California
Joyce A. O’Shaughnessy, MDCo-Director, Breast Cancer Research
Baylor Charles A. Sammons Cancer Center
Texas Oncology, PA/US Oncology,
Edith A. Perez, MDDeputy Director of the Mayo Clinic Cancer Center, Director of the Breast Cancer Translational Genomics Program and the Breast Program at Mayo Clinic,
Hope S. Rugo, MDProfessor of Medicine and Director of the Breast Oncology, Clinical Trials, and Education Program, University of California San Francisco Comprehensive Cancer Center, San Francisco, California
Andrew D. Seidman, MDProfessor of Medicine, Weill Cornell Cancer Center, Attending Physician at Memorial Sloan Kettering Cancer Center,
New York, New York
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