Breast cancer is a group of neoplasms that differ in terms of genetic and morphological characteristics and the course of the disease. The most aggressive and at the same time the least known is the so-called triple negative breast cancer – said oncologists on Thursday at a press conference in Warsaw.
As emphasized by dr hab. Tadeusz Pieńkowski, consultant for clinical oncology in the Masovian Voivodeship, has significantly improved the effects of breast cancer treatment in recent years thanks to the progress of biology and medicine. Today, therapy can and should be selected individually for patients based on the biochemical characteristics of tumor cells – when they have receptors for female sex hormones, drugs that block the action of these hormones are used, and when, due to a genetic change, they overproduce the HER2 receptor – drugs are administered that block it.
According to Dr. Anna Niwińska from the Oncology Center in Warsaw, the most excluded group of breast cancer patients are those whose cancer is considered triple negative. It does not have any of the above receptors, and the effectiveness of its treatment is still very low.
A triple negative cancer has 10-15 percent. all breast cancer patients. It is characterized by high aggressiveness – the cancer grows very quickly, metastasizes and recurs quickly. It is difficult to diagnose at an early stage as it is poorly detectable on mammography.
It happens that a patient who had good mammographic examination results presents after a few months with a breast tumor palpable. Or, the patient presents with a small tumor, which theoretically should be well treated, and in a year or two it has already metastasized to the lungs or to the brain. This is triple negative cancer – it is difficult to predict its course – explained the specialist.
Therefore, patients with this cancer should be treated very intensively from the very beginning. The biggest problem, however, is that, unlike other breast cancers, the therapeutic options here are very limited. There is not a large arsenal of drugs that can be used – it cannot be hormone therapy or drugs that act on HER2.
Only traditional chemotherapy drugs have certain effects. Taxanes and anthracyclines are the most effective, but they give an answer in 45 percent. patients with this cancer – explained Dr. Niwińska. Therefore, the average survival time in this group is still shorter than in patients with other types of breast cancer.
As Dr. Pieńkowski recalled, research on inhibitors of the PARP enzyme, which is involved in the repair of cell DNA, gives some hope for the future for patients with triple negative breast tumors.
From the recent research of prof. Jan Lubiński from the Pomeranian Medical University in Szczecin shows that in some patients with this cancer very good results could be achieved by a cheap drug used in chemotherapy for years – i.e. cisplatin. However, this applies only to those patients with a mutation in the BRCA1 gene (most tumors with this mutation are just triple negative). However, this discovery needs to be confirmed in further research.
According to Dr. Iwona Głogowska from the Oncology Center in Warsaw, various studies show that the effects of chemotherapy in patients with triple negative breast cancer can be improved to some extent by also administering an anti-angiogenic drug, i.e. inhibiting the formation of vessels that nourish the tumor and facilitate its metastasis. It is bevacizumab, which is currently used in patients with colorectal cancer and kidney cancer, but there are no indications yet for the treatment of breast cancer.
In Poland, in breast cancer, it can be used as part of the so-called non-standard therapy, which from January 1, 2010, began to be carried out as part of the therapeutic program. As assessed by Dr. Maria Górnaś, head of the Women’s Department of the Oncology Clinic of the Military Medical Institute in Warsaw, who was present at the conference, this change meant that you can now apply for the drug only in facilities that have contracted therapeutic programs, and thus worsened access to bevacizumab for patients treated in smaller centers. (PAP)
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