Triple-negative breast cancer, in need of treatment

Breast cancer is the most common cancer in women. Indeed, it affects one in eight women and there are approximately 60,000 new cases each year. In the majority of cases, it will be an adenocarcinoma. But in 10-15% of cases, the breast cancer will be of a more aggressive nature. This is called triple negative cancer. Collective The Pink Tripletscreated a year ago, campaigns for greater access to innovative treatments for women affected by this type of cancer, which often strikes younger women.

Triple negative breast cancer, what is it?

This triple-negative breast cancer includes cancers that show an absence of expression of estrogen and progesterone hormone receptors but also an absence of overexpression of the growth factor HER-2. For these tumors with increased aggressiveness, there is therefore no response to hormone therapy but also to Herceptin, a treatment for HER-2+ breast cancer. “Hormone therapy is not accessible in this type of cancer and unfortunately, we have not yet managed to deploy all the therapeutic solutions for this particular pathology” deplores Isabelle Huet, director of the Rose Up association, which helps women facing breast cancer.

What treatments are available?

Unlike more classic breast cancers, which are well known and well treated – 99% of these cancers caught very early have a 99% 5-year survival rate – triple negative breast cancers have a 20% survival rate. about. No targeted treatment is currently really effective in slowing its progression, because these triple-negative cancers are neither sensitive to hormone therapy, which blocks the action of hormones, nor to herceptin, an anti-HER2 treatment. “Vaccine therapy, which is much talked about, is not currently a treatment option either. explains Dr. Jacques Medioni, medical oncologist at the Georges-Pompidou European Hospital, “we are not at all on a molecule that has shown any effectiveness”.

The hope of immunotherapy

“In the context of immunotherapy, there is pembrolizumab or Keytruda for its trade name, which is a molecule that stimulates the immune system. It showed in a controlled trial that, associated with chemotherapy, there was a significant survival gain for patients with a predictive immune response profile, ie approximately two thirds of patients. The gain is estimated at five or six months of survival, which is enormous for patients. Median survival is then 20 months. adds Dr. Medioni, who recalls that “Keytruda and Trodelvy – or sacituzumab govitecan, a drug combining an antibody and chemotherapy – are the two major advances of the last two years, because before there was nothing”. (To find out more, read our article “New avenues of treatment for triple negative breast cancer”)

But the brakes are also administrative. According to Isabelle Huet, it is necessary “an improvement in the administrative systems because these molecules have marketing authorizations (AMM) but no reimbursements (…) The deadlines are still too long“.

The search continues

These first results of treatments against triple negative breast cancer are possible thanks to clinical research. Dr. Jacques Medioni is precisely the national coordinator of a therapeutic trial called Atractib, currently in phase two. “It focuses on the evaluation of the efficacy and safety of first-line atezolizumab in combination with paclitaxel and bevacizumab (Avastin) in patients with advanced or metastatic triple-negative breast cancer. says Dr. Medioni.

Two treatments also give promising results, in a metastatic situation. “These are targeted therapies in the case of cancers with BRCA1 and BRCA2 mutations: olaparib and talazoparib (Talzenna)” further specifies the specialist.

Additional hope in the fight against this aggressive cancer which affects 13,000 women each year.