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An exclusive “Ask the Expert” Q&A session with the esteemed medical oncologist from Memorial Sloan Kettering Cancer Center, Dr. Tiffany Traina, a luminary in the field of oncology, particularly in the battle against TNBC.
Below is a summary of the discussion with Dr. Traina.
In the evolving field of triple-negative breast cancer (TNBC) treatment, recent advancements have greatly expanded standard care options, introducing innovative approaches to improve patient outcomes. Here’s a breakdown of standard treatments, the role of immunotherapy, and how clinical trials are reshaping the future of TNBC care.
Standard Treatments for TNBC
The approach to TNBC treatment is largely influenced by the stage of cancer, tumor size, and lymph node involvement:
Early-Stage TNBC (Stages 1-3): For small tumors (under 2 cm) without lymph node involvement, the standard is upfront surgery to remove the tumor, followed by systemic chemotherapy to prevent recurrence. Chemotherapy regimens are chosen based on the tumor’s characteristics and the patient’s health to minimize side effects while maximizing effectiveness.
Larger Tumors and Lymph Node Involvement: When tumors exceed 2 cm or if lymph nodes are affected, the approach is often to delay surgery in favor of initial chemotherapy combined with immunotherapy to shrink the tumor, making surgical removal more effective and less invasive.
Immunotherapy: A New Era in TNBC Treatment
TNBC is the only breast cancer subtype currently benefiting from FDA-approved immunotherapy. This therapy leverages the body’s immune system to target cancer cells, often in combination with chemotherapy for optimal impact. Early use of immunotherapy has shown promising results, with many tumors shrinking significantly or even disappearing entirely. Additionally, studies show that pairing chemotherapy with immunotherapy can lead to improved long-term survival rates for women with early-stage TNBC.
- Immunotherapy Before Surgery: This preoperative approach helps shrink tumors, sometimes even eliminating them, which has been shown to improve breast cancer survival rates.
- Ongoing Immunotherapy Post-Surgery: Depending on surgery results, patients may continue immunotherapy or begin a new treatment, such as a chemotherapy pill, to further improve survival chances.
Personalized Treatment Based on Genetic Mutations
Patients with genetic predispositions, such as BRCA1 or BRCA2 mutations, may benefit from additional treatments. For example, taking the oral medication olaparib post-surgery has shown to improve survival rates in patients with these mutations. This tailored approach exemplifies precision medicine in action, offering patients customized care based on genetic testing and individual responses to initial treatments.
The Role of Clinical Trials
Clinical trials play a crucial role in advancing TNBC treatment. Patients are encouraged to ask their healthcare providers about ongoing trials, especially as these trials may offer access to cutting-edge therapies and treatments not yet widely available. Health apps and resources can also help patients stay informed about trial opportunities, making it easier to discuss options with care teams and gain insights into potential benefits.
Conclusion
The standard of care for TNBC has transformed dramatically, now incorporating immunotherapy and precision medicine to offer hope and improved outcomes for patients. With ongoing research and new clinical trials, patients have more options than ever. These advancements highlight an era of personalized medicine, bringing us closer to finding the most effective, tailored treatments for each individual battling TNBC.
For those navigating a TNBC diagnosis, having discussions about standard treatments, immunotherapy, and clinical trials with healthcare providers is invaluable, offering insights that could impact treatment decisions and long-term survival.