Clinical Trials for the treatment of triple-negative breast cancer
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Today there are 43 clinical trials for triple-negative breast cancer in Spain:
Find out which sites you can participate in by downloading the App or logging in to the web version.
What is the treatment of triple-negative breast cancer?
Triple-negative breast cancer, or TNBC, is a type of breast cancer that does not have any of the receptors that are commonly found in breast cancer (estrogen, progesterone and HER2). Because of this lack of receptors, it cannot be treated with hormonal or HER2-targeted therapies, limiting its primary treatment to conventional chemotherapy and surgery.
Treatment for stage I - III triple-negative breast cancer
This type of tumor can be approached in two ways depending on the timing of surgery.
It is important to remember that, in addition to medical treatment, it is recommended to follow a balanced and healthy diet. Psychological support can help to cope with the emotional impact of the disease, and joining patient advocacy groups can provide additional support throughout the disease process. Taking care of your well-being helps you to have a better quality of life.
Surgery in first order
Surgery for triple-negative breast cancer may be performed before systemic treatment, depending on the tumor size. If the tumor is small enough to be removed, the physician and the patient will consider whether to perform a conservation surgery (lumpectomy) or a mastectomy (with or without reconstruction). A biopsy of the lymph nodes will also be performed to evaluate the involvement of malignant cells and to decide whether they should be removed.
Subsequently, adjuvant chemotherapy will be administered to reduce the risk of recurrence. In patients with the BRCA mutation, chemotherapy can be combined with olaparib, a PARP inhibitor.
Second order surgery
This therapeutic plan seeks to reduce the size of the tumor using chemotherapy before surgery (neoadjuvant), with the possibility of including pembrolizumab (a monoclonal antibody). In case surgery reveals the persistence of malignant cells in the removed tissue after chemotherapy, the medical team may suggest several alternatives:
Administer capecitabine (oral chemotherapy) for up to 24 weeks. This treatment aims to improve patient survival.
Recommend pembrolizumab or atezolimab (monoclonal antibodies directed against the PD-L1 protein) to reduce the risk of recurrence.
For patients with BRCA mutation, continue taking olaparib for one year to avoid recurrence and improve survival.
In specific cases, both radiotherapy and surgery can be used.
Treatment for stage IV triple-negative breast cancer
The tumor has spread to other organs, generating bone, brain, liver or lung metastases. At this stage, treatment is oriented towards the chronicity of the disease, prioritizing the patient’s quality of life.
Chemotherapy continues to be the primary treatment for triple-negative breast cancer, with the use of compounds such as anthracyclines, paclitaxel, docetaxel, vinorelbine, capecitabine, carboplatin, gemcitabine, cisplatin or eribulin. In patients with BRCA mutation who do not respond to chemotherapy, olaparib or talazoparib is recommended.
Combining pembrolizumab with chemotherapy is recommended in patients with PD-L1 protein (1 in 5 cases). In situations where two different lines of treatment have already been employed, the use of sacituzumab govitecan, a recently approved antibody conjugate, may be considered.
It is important to remember that breast cancer affects both women and men (1%-2% of breast cancer diagnoses are in men).
The positive impact of clinical trials on the treatment of triple-negative breast cancer and its metastases
Despite breast cancer being the most studied tumor in the world, in the case of triple-negative breast cancer, therapeutic options are limited. Fortunately, numerous lines of research are underway to develop new diagnostic methods, treatments and personalized therapeutic plans according to the patient’s condition.
Leaders in breast cancer research, such as Dr. Javier Cortés, believe that clinical trials may be the best therapeutic option available on many occasions. Patients who participate in a clinical trial at any stage of their disease can benefit from access to new therapies, a personalized treatment plan, control of symptoms and side effects that positively impact the quality of life and, for added security, increased follow-up by healthcare personnel.
Finding a research treatment when you are diagnosed with cancer is overwhelming, especially when the information is so scattered and confusing. MatchTrial’s mission is to help patients with a clinical trial finder that makes looking for treatment options quick and easy. With a user-friendly interface, the filtering system allows patients to easily access clinical trial information. Our team of nurses will accompany patients during the search process answering any questions that may arise. Our aim is to provide tools to help patients make informed decisions.
New research treatments for triple-negative breast cancer
Improving prognosis is a priority in clinical research. New treatments for triple-negative breast cancer are currently being developed through clinical trials such as:
Conjugated antibodies targeting TROP-2 (trophoblast cell surface antigen 2) overexposure.
Cell therapy-based immunotherapy using tumour-infiltrating lymphocytes (TILs)
Bromodomain inhibitors
These new therapies seek to identify and target only malignant cells, which could result in more effective and safer treatments with fewer side effects for patients.
Clinical trials seeking to improve current treatment for triple-negative breast cancer
The other primary objective of the studies is to improve current therapies to reduce treatment’s adverse effects and sequelae. Different drugs are being studied in combination to improve efficacy, quality of life and survival. Some examples of these combinations under research are:
Monoclonal antibodies targeting IL 1RAP + chemotherapy (gemcitabine and carboplatin).
Targeted therapies such as govitecan sacituzumab + pembroluzimab.
To improve the patient’s quality of life by reducing undesirable effects derived from sacituzumab govitecan by administering loperamide + G-CSF (white blood cell stimulant).
References
American Cancer Society, 2023: Tratamiento del cáncer de seno triple negativo
BreastCancer.org, 2023: Cáncer de mama triple negativo
Sociedad Española de Oncología Médica, 2023: Cáncer de mama: tratamientos según estadio
Clínic Barcelona, 2022: El Clínic comienza un ensayo de inmunoterapia basada en linfocitos infiltrantes de tumores (TILs) en cáncer de mama triple negativo