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Posts tagged ‘triple negative breast cancer’

Do Checkpoint Inhibitors work in Triple Negative Breast Cancer?

SABCS BannerSan Antonio – The San Antonio Breast Cancer Symposium (Twitter #SABCS14) is underway, and one of the key questions everyone is asking is do checkpoint inhibitors work in Triple Negative Breast Cancer (TNBC)?

TNBC is defined as the absence of estrogen receptor (ER), progesterone receptor (PR) and HER2 protein expression. This means that treatments aimed at these targets such as aromatase inhibitors and Herceptin are unlikely to work in TNBC.

TNBC represents approximately 15% of breast cancer patients in the U.S, and to put this number into perspective, around 200,000 women have the disease, with 40,000 deaths each year. Globally, there are an estimated 1 million cases of breast cancer, of which 170,000 are triple-negative (ER-/PR-/HER2-).

The only currently available treatment for TNBC is chemotherapy, but sadly patients often do not live long, and rapidly progress. Progression-free survival (PFS) is estimated to be around 4 months in TNBC. This means there is a real unmet medical need for effective new treatments.

Checkpoint inhibition of the programmed-death 1 receptor (PD-1) such as pembrolizumab (Merck) and the ligand (PD-L1) e.g. MPDL3280A (Genentech/Roche) can increase the effectiveness of a body’s T cells to fight cancer. Are checkpoint inhibitors the future in TNBC and will they offer hope to patients?

Some early preliminary clinical data is being presented this week at SABCS. Subscribers can login below or you can purchase access to read more about what this data signals about the potential of checkpoint inhibition in TNBC.

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Novel targets and approaches in triple negative breast cancer

“You may say I’m a dreamer

But I’m not the only one.”

John Lennon, Imagine

As part of our ongoing series on the AACR Previews, today I want to take a closer look at some interesting scientific and clinical data in triple negative breast cancer (TNBC).  One reason for this is that we need to remember that the disease, as currently defined, is essentially what’s left after taking out the ER+, HER2+ and inflammatory breast cancer subsets. In other words, it’s a very heterogeneous catch-all population, making clinical trials rather challenging at best. It also means that the chances of success in general all-comer trials is rather low.

It is my hope that as we learn more about the biology of this disease, we may see further subsets be defined by molecular peculiarities, much in the same way that gastrointestinal stromal tumours (GIST) were defined by KIT expression and CD117. Once we have more homogenous subsets, it will be easier to conduct trials just looking at those specific patients, thereby improving the chances of clinical success with therapeutic intervention.

There’s been a lot of work focused on this area over the last few years, so it seems a good point to find out where the progress has got to.

Without much further ado, what can we learn about the biology of TNBC from AACR this year and which potential new targets might emerge?

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MBCC: Will NGS change the way we treat metastatic breast cancer?

Following on from yesterday’s update on how proteomics and genomics can help us make better decisions in breast cancer at the Miami Breast Cancer Conference (#MBCC14) organised by PER, today also looks at the complexity of genomics, but from a different lens – can genomics impact the way we actually treat patients?

Interestingly, last week there was a rumour (unconfirmed) that Dr Debu Tripathy (UCLA) was heading to MD Anderson to head up the breast cancer division following Gabriel Hortobaygi’s retirement. That move was confirmed yesterday, with a tweet from Dr Naoto Ueno, who is part of the group:

His talk on the increasing role of genomics in breast cancer on Friday was engaging, thoughtful and well delivered.

It also made me (and several others) stop and think.

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What to watch for at San Antonio Breast Cancer Symposium

Whew, having just finished the American Society of Hematology (ASH) meeting, we run on to the breast cancer symposium in San Antonio (SABCS), making for a very busy week of data deluge!  Our Post ASH analysis will also run concurrently for a few days.

There are also a number of interesting areas to look out for in terms of interesting breast cancer developments.

Premium subscribers can find out more about the following below:

Companies: Roche, GSK, AbbVie, AstraZeneca, Novartis, Lilly
Drugs: Herceptin, Avastin, Perjeta, Tykerb, veliparib, olaparib, BKM120, ramucirumab, PD-1, PD-L1

Here’s a quick preview of some of the landmark data emerging from this conference, some positive, some negative.

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