VIDEO: Research focusing on learning more about triple-negative breast cancer

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Future research has been gearing really towards understanding more and more about the heterogeneity of triple negative breast cancer. Now, we know from almost five years ago that triple negative is not one type. It's almost close to six, seven subtypes that have distinct biological behavior. And although this information is not clinically transmittable now, a lot of the research has been understanding what these subtypes are, how they interact with each other. One of these subtypes for example, is the immunomodulatory, which is typically more immunosensitive. Which translates usually to those folks who benefited from the immunotherapy. So a lot of the future research has been focusing on, you know, again these subtypes, and trying to tailor treatments that are fairly novel. And really looking into how we can target what we call driver mutations and driver pathways of triple negative breast cancer. Along these, you know, some examples are AR or androgen receptor-based therapy typically for luminal androgen receptor subtype, combination immunotherapy for the immunomodulatory subtype, novel chemotherapy/antibody drug conjugates typically for the basal like one and two subtypes, and so on and so forth. And these are just the trend of the biology going forwards. Antibody drug conjugates, is a very active area of research, and I think it will really explore a lot of different combinations over the next few years. However, there's a lot of phase ones that are a research that focus on these subtypes that I mentioned. In fact, I believe there is a very interesting upcoming trial between University of Chicago and Memorial Sloan Kettering within the TBCRC consortium that is looking into using androgen receptor blockade, the same drugs we use for prostate cancer, in patients who have androgen receptor activity, triple negative breast cancer. One focus on the triple negative breast cancer has been on patients with brain mets or brain metastasis from breast cancer. And these patients are typically a small subset, however an unfortunate subset. A lot of the research has been geared towards finding the best agents that can penetrate the blood-brain barrier and have an intracranial activity. We have already data on ENHERTU, which is the antibody drug conjugate that is used for HER2-low triple negative breast cancer as well as certain other types of chemotherapy. And immunotherapy has some interconnectivity, but this is an area of active research as well. Another clinical trial that is actually very dear to my heart is the trial that looks for what we call ER beta positive breast cancer. It's trial has been designed at Mayo Clinic by various team, international recognized breast cancer researcher Dr. Matt Goetz. Who I had the pleasure of working with at some point back in my post-doc time. This trial actually is very unique. It looks into again the biology of triple negative breast cancer, specifically the subtype that has what's called estrogen receptor beta. And it uses estrogen as a treatment for that subtype. Estrogen has been a very old treatment for breast cancer. We stopped using it because it has some side effects. Now this trial is bringing it back for that very small population that do have that receptor. And I think it's a fantastic trial, because for the first time maybe in the history of breast cancer you get a treatment that actually makes you feel better, not worse. For clinicians, I think one thing that, you know, I feel like is always worth reminding is clinical trials are a very viable option even to standard of care. Clinical trials can replace first, second, and third line chemotherapies as well as later line chemotherapies. And the reason I say that is because a lot of the treatments that we highlight today that I said have gained approval over the past few years that actually benefited patients, have been clinical trials. And have been attributed well before then, years and years. So the beauty of clinical trials is that they can bring tomorrow's treatments to today's patients. and I think it's a varied option. A lot of the physicians think of clinical trials as a last option, you know, once everything else is not working. And that is true for some of the clinical trials, what we call early phase. However, clinical trials are for all routes of treatment. UAB does have a fantastic website that was just launched few weeks ago really that lists all clinical trials that we have active. And you people can search it and narrow down to triple negative metastatic, and they will tell them all the trials that there is.