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Chemotherapy Only Option Now for Triple Negative Cancers, but New Drugs Being Tried

by Gopalan on  June 17, 2008 at 12:55 PM Cancer News   - G J E 4
 Chemotherapy Only Option Now for Triple Negative Cancers, but New Drugs Being Tried
Triple negative cancers are particularly aggressive and have a very high rate of recurrence or relapsing.

Chemotherapy is the only option now, but new drugs are being tried out.
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Dr. Funmi Olopade, a professor of medicine at the University of Chicago, told CNN,

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"If a patient responds well to chemotherapy, there's a very good chance of curing the disease.

"The challenge we have is when the cancer comes back," she added. "Right now, we don't have any effective way to treat it, and that's why when it comes back, it tends to be deadly."

Olopade is hoping better drugs will be available in the next two to five years that will help eradicate triple negative cancer cells.

A clinical trial is on evaluate the efficacy and safety of the addition of Avastin (bevacizumab) to standard adjuvant therapy in patients with triple negative breast cancer. The drug cuts blood supply to cancer cells.

Adjuvant therapy uses chemotherapy drugs, radiation, hormone therapy, targeted therapy or a combination to help destroy any cancer cells that were not removed during your breast cancer surgery. Its goal is to decrease the risk of your breast cancer coming back.

It is only in the last few years that professionals studying breast cancer have concluded that breast cancer is not one disease, but many different forms of cancer all originating in the breast. Depending on its stage of diagnosis, triple negative breast cancer can be extremely aggressive and more likely to recur and metastasize than other subtypes of breast cancer.

These subtypes of breast cancer are generally diagnosed based upon the presence, or lack of, three "receptors" known to fuel most breast cancers: estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2). The most successful treatments for breast cancer target these receptors.

Unfortunately, none of these receptors are found in women with triple negative breast cancer. Hence treatment becomes difficult.

Of the estimated 180,000 women who learn they have invasive breast cancer this year in the United States, about 15 percent will have triple negative.

"They appear to be more common in younger and black women, but to date, they have not been adequately researched, particularly among minority populations," Mary Jo B. Lund of Winship had noted two years ago.

To assess racial differences in the prevalence of triple-negative invasive breast cancers, researchers tested breast tumors from 117 black and 362 white Atlanta women aged 20 to 54 years.

When stratified by race, 46.6% of black women had triple-negative tumors, compared with 21.7% of white women, even after adjustment for age and stage of disease at diagnosis. "This translated to a 2.71-fold increase in risk for black women," Dr. Lund said.

Dr.Olopade said, "We know that women with a family history of breast cancer who have a BRCA1 mutation are most at risk."

BRCA1 is a major breast cancer-causing gene that was identified 14 years ago. Women born with the defective gene have a higher chance of getting breast cancer and at a younger age.

She encouraged all young women, no matter what their race, to talk to their doctor about doing a risk assessment for the BRCA1 gene. If there is a family history of the gene mutation, some physicians may tell a woman not wait until she turns 40 to get her first mammogram.

"We begin screening as early at 25," Olopade said. "Many of the women are surviving. They are beating the odds of dying because they know they can do preventive approaches to reduce their risk of dying."

She also wants to explore further whether triple negative rates are higher among women who do not breastfeed their children. "It's that first pregnancy and first breastfeeding that really allows the breast to become fully mature," she said.

She worried that in general, "African-Americans are not likely to breastfeed, as they are getting in the work force and returning to work soon after childbirth."

Even with several clues, Olopade acknowledged that researchers still don't know a lot about triple negative breast cancer and more study is needed.

Source: Medindia
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