Friday, July 1, 2011

Six TNBC Subtypes Discovered, with Different Responses to Chemotherapy

Scientists say triple-negative breast cancer (TNBC) can be divided into six distinct subgroups, all of which respond differently to chemotherapy. In an article published in the July 2011 issue of Journal of Clinical Investigation, researchers from Vanderbilt University's Ingram Cancer Center say the disease can be grouped according to:

• two basal-like subtypes, which they call BL1 and BL2; these are correlated with cell cycle and DNA damage response genes
• two "mesanchymal" types, which they call M and MSL; these correlate to genes involved in cell differentiation and growth factor pathways
• an immunomodularity type, which they call IM, correlated with immune system genes
• a luminal group,which they call LAR, correlated with androgen, or the male sex hormone.

The groups respond differently to chemotherapy:

• BL1 and BL2 respond to cisplatin
• M and MSL respond to dastanib and an experimental drug NVP-BEZ235
• LAR respond to biculatamide

Read the entire news release from Vanderbilt here.

7 comments:

Anonymous said...

What puzzles me about this is whether it means TNBC does not respond to the chemo most of us had, AC + T.
Susan

Patricia Prijatel said...

Susan: No, it does not mean that--plenty of studies have shown that ACT and TAC are especially effective against TNBC. What this study does is move us closer into more targeted therapy, which is especially important with the more aggressive forms of TNBC.

Anonymous said...

Thank you Patricia.
Susan

Kim said...

Pat--continued thanks for bringing awareness to what is in the studies. Although when we read studies like these, it is a bit frightening to be reminded of the agressiveness of TNBC, but I am also so excited to hear about the new research and new possibilities for treatment. Thanks so much for your continuing education on TNBC.

Patricia Prijatel said...

Kim: I look at this as indicating that some types of TNBC are actually not that aggressive, especially the luminal subtype. And this research just reinforces the fact that TNBC is not one disease. But, yes, having docs finding new therapies and working to understand the disease is great news. Pat

Sherry said...

I have been considering the Phase III Metformin drug trail for TN that is currently taking place in Canada. I have not jumped on board yet because I found an artical claiming a subtype of TN, MDA-MB-435 increased its production of VEGF in response to the metformin, causing tumor progression.
http://www.breastcancerchoices.org/files/lowerinsulinforbreastcancer.pdf

My oncologist was not aware of this and is unable to tell me if my TN was this subtype. I believe mine was basal as it contained squamous differentiation. Are you aware of this subtype and how to go about finding out if a person had that subtype?
I would like to be included in the trial but that is not a risk I am willing to take at this time.

Thanks
Sherry

Patricia Prijatel said...

Sherry: Finding your subtype can be tricky, as docs typically go no farther than BRCA and basal-type tests--and many do not even do that. Researchers use cells from tumors to study the disease, which ends up with the kind of research that helps define subtypes, but this kind of testing is usually restricted to the lab and is used only for research purposes, not diagnosis. You might contact the docs who are leading the study and ask them. Who knows, the study might be a way of determining your subtype. Whatever the case, your pathology report should clarify whether or not yours was basal-like--if this is not on your report, the pathologist might be able to tell you. And good luck. Pat