TNBC: Taking on the Toughest Breast Cancer
Oct 08, 2017 Cedars-Sinai Staff
Breast cancer treatment has come a long way—and with women being widely screened, it's a cancer that's likely to be caught early, when it's most treatable.
Many breast cancer patients have options today, including "smart drugs" that home in on certain mutations.
But one type of breast cancer remains especially difficult to treat: triple negative breast cancer (TNBC). The problem? TNBC tests negative for the 3 mutations that can be targeted specifically by cancer drugs.
TNBC occurs in 10–20% of women diagnosed with breast cancer. Not only does TNBC fail to respond to common treatments, it is likely to spread and recur.
Investigators at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute are researching revolutionary techniques to improve quality of life and outcomes for these patients.
A technology that freezes tumors while using medications that activate the body's immune system to fight cancer sounds pretty futuristic—but it's being studied at Cedars-Sinai right now.
Dr. Heather McArthur, medical director of Breast Oncology, is studying the use of cryoablation to break tumors into pieces that can be targeted more easily by the immune system.
At the same time, researchers are administering drugs to generate an immune response that specifically targets the tumor. The therapy could also be effective in helping the immune system recognize and eradicate cancer cells if the disease returns.
Dr. McArthur says her research may be important for triple negative breast cancer for 2 reasons:
- TNBC appears to interact with the immune system more than other breast cancers
- TNBC tends to be more responsive to changes in immune activity
"This might be because triple negative breast cancer is more mutated, or altered, so it presents more abnormal or foreign-appearing information for the immune system to react to," Dr. McArthur says.
Combining immunotherapy with disruptive, local strategies such as cryoablation or radiation is a major area of breast cancer research at Cedars-Sinai.
Xiaojiang Cui, PhD, a research scientist and associate professor of Surgery at Cedars-Sinai, says that each TNBC tumor is distinct, so he probes tumor tissue to find differences he can exploit.
"We take cells directly from a breast cancer patient and we immediately do experiments with isolated live cells," Cui explains.
The aim is to uncover which drugs might destroy that specific patient's cancer cells. Subtle differences in each individual's tissue often dictate how they will respond to treatment.
Cui's team is also exploring which aspects of a tumor cell might be predictors for life-threatening metastatic cancer. He hopes this research will lead to better diagnostic tools and personalized treatment options for patients who are confronting TNBC.