Top Triple-Negative Breast Cancer Research: 2013

Last year was a lively one for research on triple-negative breast cancer.  Below is my list of the year's top studies—all pointing toward understanding what makes TNBC tick, which will ultimately lead to treatment and a reduction in the risk of recurrence.  Remember, though, that the road from research to clinical practice can be long and rocky, so most of these treatments  won't be immediately available.  Still, this list points to a rich reservoir of inquiry and information—which is good news for those of us on the TNBC Road and for those who follow us.

Are Common Bone Drugs the TNBC Follow-Up Treatment We’ve Been Seeking?

Bisphosphonates such as Zometa and Reclast reduced the risk of bone metastases following breast cancer in post-menopausal women by 34 percent in research presented at the 2013 San Antonio Breast Cancer Symposium. And they reduced the risk of death in that same group by 17 percent, regardless of receptor status, node involvement or previous chemotherapy.   More.

Genetic Details of Triple-Negative Breast Cancer

Beyond its most basic definition—negative for receptors for estrogen, progesterone and Her2/neu—triple-negative breast cancer has unique genetic characteristics.  Research published in the journal Cancer Research has outlined some of TNBC’s genetic associations.   Once they know what it is rather than what it isn't, they can target it.  Put a big red bull’s eye on its nasty old back.  More.

New Drug Regimens Can Lead to Improved Outcomes for Women with Stages II and III TNBC Adding the chemotherapy drug carboplatin to standard treatment improved outcomes for women with triple-negative breast cancer in two studies presented at the 2013 San Antonio Breast Cancer Symposium.  Both measured pathological complete response (pCR), which is recognized as a positive marker for overall survival.  The second study also showed improved outcomes using bevacizumab (Avastin). More.

Lymphocytes May Signal Chemo Response in TNBC

Tumor-infiltrating lymphocytes may become an additional factor in determining which types of triple-negative breast cancer respond best to chemotherapy.  Seventy-five percent of tumors with the highest levels of lymphocytes—researchers call this lymphocyte predominate breast cancer (LPBC)—had a pathological complete response to doxorubicin and taxane plus carboplatin when compared to non-LPBC tumors. The results came from the GeparSixto trial (GBG 66) in Germany.  More.

High Fat Diet in Puberty Linked to Basal-Like Breast Cancer

Young women who eat excess amounts of saturated fats during their teenage years increase their risk of basal-like breast cancer, according to a study published in Breast Cancer Research. Many basal-like tumors are also triple-negative. More

Metformin: New Agent Against TNBC?

The diabetes drug Metformin can effectively reduce breast cancer risk that is associated with insulin resistance and was directly correlated with Ki67 status, according to research in the British Journal of Cancer.  TNBC has shown links to insulin resistance in previous studies, and many TNBC tumors are positive for Ki67, so this could be additional support for considering metformin as a treatment for TNBC.  More.

Restorative Yoga Can Help Trim Fat

Yoga’s health benefits may go beyond stress reduction – a study funded by the National Institutes of Health (NIH) found that for overweight women, restorative yoga may offer a way to actually trim subcutaneous fat.  Obesity is a risk factor for breast cancer, including TNBC. The benefits of restorative yoga – a form of the practice that emphasizes relaxation over flowing movements or challenging balance poses – compared favorably with simple stretching when tested among a group of women who were clinically obese.  More.

New Imaging Technique Can Determine Cancer Subtype and Response to Treatment

An optical imaging technique that measures metabolic activity in cancer cells can accurately differentiate breast cancer subtypes, and it can detect responses to treatment as early as two days after therapy administration, according to a study published in Cancer Research, a journal of the American Association for Cancer Research.  More.

Existing Drugs Kill TNBC Drugs By Targeting Their Own Waste

Triple-negative breast cancers may be vulnerable to drugs that attack the proteasome, a cellular structure that acts as the cell's waste disposal, breaking down damaged or unneeded proteins, according to a new paper in Cancer Cell.  In lab tests, researchers selectively "turned off" genes in triple-negative tumor cells. When turned off, the cells die. These data suggest that triple-negative breast cancers may respond to treatment with drugs similar to bortezomib (Velcade), which is used in multiple myeloma.  More.

Protein May Be Path to Targeted TNBC Treatment

A protein called Numb (seriously) may  promote the death of cancer cells by binding to and stabilizing the tumor suppressor protein p53, which is implicated in many cases of triple-negative breast cancer, according to research published in the May 23^rd issue of Molecular Cell.   When Numb is reduced by the Set8 enzyme , it will no longer protect p53.  More.

HMGA1 Turns TNBC Cells Back to More Normal and Slows Their Growth

Researchers at Johns Hopkins have identified a gene that, when repressed in tumor cells, puts a halt to cell growth and a range of processes needed for tumors to enlarge and spread to distant sites. The researchers hope that this so-called “master regulator” gene may be the key to developing a new treatment for tumors resistant to current drugs.  More.

Diamonds May Be A TNBC Girl's Best Friend

UCLA researchers  have developed a potential new treatment for triple-negative breast cancer that uses nanoscale, diamond-like particles called nanodiamonds.  Nanodiamonds are between 4 and 6 nanometers in diameter and are shaped like tiny soccer balls. Byproducts of conventional mining and refining operations, the particles can form clusters following drug binding and have the ability to precisely deliver cancer drugs to tumors, significantly improving the drugs' desired effect. In the UCLA study, the nanodiamond delivery system has been able to home in on tumor masses in mice with TNBC.  More.

Omega 3 Fatty Acids in Fish Oil May Slow Triple-Negative

Researchers from Fox Chase Cancer Center have found that omega-3 fatty acids and their metabolite products slow or stop the proliferation, or growth in the number of cells, of triple-negative breast cancer cells more effectively than cells from luminal types of the disease. The omega-3s worked against all types of cancerous cells, but the effect was observed to be stronger in triple-negative cell lines, reducing proliferation by as much as 90 percent. More.

SOX11 and p53 May Spell Unique Development of Triple-Negative Breast Cancer

Could you create a breast cancer tumor in mature mice by reactivating how embryonic breast cancer cells develop?  And, if you could, what would you learn?  In a study published in the journal Breast Cancer Research, scientists discovered that basal-like  breast cancers with the BRCA1 mutation—many of them triple-negative breast cancers—grow differently than other cancers.  In fact, the way they grow predicts the prognosis of the tumor. More.

Could Copper Depletion Be a Cure for Metastatic TNBC?

An anti-copper drug compound that disables the ability of bone marrow cells from setting up a "home" in organs to receive and nurture migrating cancer tumor cells has shown surprising benefit for metastatic triple-negative breast cancer. Results of a phase II clinical trial conducted by researchers at Weill Cornell Medical College and reported in the Annals of Oncology shows that patients who are copper depleted show a significantly reduced risk of relapse.  In fact, only two of 11 study participants with a history of advanced triple-negative breast cancer relapsed within 10 months after using the anti-copper drug, tetrathiomolybdate (TM). More.

Scientists Map TNBC's Metastatic Path

Cancer Scientists at Weill Cornell Medical College have discovered the molecular switch that allows triple negative breast cancer cells to grow the amoeba-like protrusions they need to crawl away from a primary tumor and metastasize throughout the body. Their findings, published in Cancer Cell, suggest a novel approach for developing agents to treat cancer once it has spread. More.

Protease May Help Define New Subset of TNBC—and Lead to Treatment.

Researchers at St, Louis University have  found a molecular signature that may define a particular subset of triple-negative breast cancer,  which can ultimate lead to target therapy for that group of patients.  In specific, they have uncovered a pathway responsible for the loss of 53BP1 in TNBC tumors related to the  BRCA1 mutation. Loss of BRCA1, they discovered, increases the expression of the protease cathepsin L (CTSL), which causes the degradation of 53BP1. Cells that have lost both BRCA1 and 53BP1 have the ability to repair DNA and proliferate. That means the protease helps cancer cells with faulty BRCA1 survive—it is a defined bad guy in TNBC growth.  And, when we know who the bad guy is, we can stop looking at ways to stop him in his mean old tracks. More

Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

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How to Counter the Side Effects of Chemo

Toward the end of my chemo treatment, my husband and I decided to celebrate my progress (any excuse for a celebration), so we went to eat at Red Lobster. Their cheese biscuits are one of my favorite parts of a meal there. This time, though, the biscuits tasted like lard. No cheese, no yummy breast taste. Just lard.

Such were the wonders of chemo that nobody told me about.

I learned a great deal on my own, so to spare you that charm, here are some of the side effects of the chemo I had—four rounds of dose-dense Adriamycin (Doxorubicin) and Cytoxan (cyclophosphamide) every two weeks—and some suggestions for how to deal with those effects. AC, as this regimen is called, is fairly common for hormone-negative cancers, including triple-negative,  that have not spread to the lymph nodes.

Chemo, in general, kills fast-growing cells, which are often cancer cells. That’s the good side of those toxins being pumped into you. However, your body has other fast-growing cells that are also affected—in your hair, the lining of your mouth, and digestive tract. Killing these changes your body. And I was not prepared for most of that.

I went through chemo fine, for the most part, given that I was going through chemo. I kept active, ate healthy, and spent marvelous time with my friends and family. But, as with all other aspects of this lovely journey, I could have been better informed.Losing your hair. This chemo effect is the most understood and expected. My doctor told me it would happen in the third week of chemo and, sure enough, that’s when my hair literally began coming out in chunks. Some women prepare for this ahead of time by getting their head shaved before the hair falls out. I wanted to be normal and natural for as long as I could. So, one warm June day, my hair came out like dead grass in an abandoned lot, and I literally pulled the rest out. Yes,  I pulled my hair out, and I will never be able to use that metaphor again. My husband shaved the rest.

Losing your hair is so emblematic of having cancer that the more you can address this head-on (no pun honestly intended), the better. Some women paint their heads; others have friends who also shave theirs in a gesture of solidarity. I just got a couple of pretty cool wigs and simply smiled when people complimented me on my new ‘do.

Whatever makes sense for you.

A friend did tell me that, because I am tall, I would look elegant in long scarves and could make a great fashion statement. I wanted to tell her to make her own damn fashion statement, but I know she was honesty trying to be supportive, so I said nothing. (I found, though, that I could not keep scarves on; they just kept sliding off my stupid bald head.)Changes in your mouth. I did not expect this in the least. Because the cells on the lining of my mouth were killed, I lost a good deal of my sense of taste, which is why those biscuits tasted like lard. My acupuncturist suggested buying some Japanese plum sauce, which has a tangy taste and sort of shook up what taste buds remained. (She also told me the other day that my tongue had looked like raw meat at the time. It did feel especially raw.) I also found that chocolate malts tasted quite good.

The bigger mouth problem, though, was mouth sores. Lots of them. Doctors call this oral mucositis and recommend a variety of things to help it, including “miracle” or “oncology” mouthwashes and antibiotics. I found an over-the-counter version that had hydrogen peroxide. Other than making me foam at the mouth like Cujo, it worked fine. I suspect that a good salt-water rinse would work as well.Digestive tract pokiness. One result of the loss of some of the cells in your digestive tract is that your digestion slows down. This is for sure the nastiest side effect of chemo, and no doctor has ever talked to me about it, but chemo patients talk about it all the time. Serious constipation. Serious. I took a natural laxative, Senna Plus, which worked OK. I often had to overdose, plus I also resorted to plain old-fashioned charmers like Milk of Magnesia.  The Mayo Clinic offers some good information on laxatives here.

I started taking a green drink every morning, a healthy tonic I still take. Green drinks are generally high in fiber and rich in antioxidants and vitamins. So they’re good for getting your digestion going and fighting the cancer. Oprah’s medical guru, Dr. Oz (really, Oz?) has a recipe online for his green drink here.

I actually do two green drinks. In the morning, I have a powdered version that has spirulina, sea grass, organic greens, plus vitamins and minerals, like Barlean’s Green.  In the evening, my husband makes me a fresh juice of carrots, kale, cabbage, and parsley, with apples and lemon for taste. Full of antioxidants and heavy on cancer-fighting cruciferous veggies.

The green drinks together, I think, helped move my digestion along.

I also found that I needed to increase the amount of magnesium I took, which is often a cause of constipation in folks without chemo, especially if they are taking calcium.

And exercise is essential.  I walked two miles most days, and that helped.  The more I walked, the better.Digestion tract speediness. Nausea is another effect we expect, although one oncologist told me that anti-nausea drugs added to the chemo cocktail have eliminated this problem. As if. My husband and I believed this, and we went out for lunch after my first chemo—at the suggestion of a helpful nurse I could strangle. Like a couple of certifiable idiots, we went to a great Italian restaurant where I ate spaghetti with meat sauce. I was sick for hours until I threw up the entire meal. I did not want meat sauce for years after, nor did I want to even walk into that restaurant, as though it were at fault.

I learned to eat small meals on chemo days, usually bland things like soups and toast or crackers.  I had plenty of liquids, and I went to the acupuncturist beforehand. I usually had mild nausea for about 24 hours after chemo, but nothing serious.

My sense of smell, which has always been acute, remained lively, so the smell of even bland things like mashed potatoes often turned me off. We resorted to eating as many fresh foods as we could, which is also a highly healthy way to go.

Three years later, I still think about those lardy biscuits. My taste buds got back into shape within a month or two of chemo. Now, the biscuits taste as they should—creamy, crunchy, and cheesy. I know, though, that behind all those goodies, there is lard. And that is one lesson of chemo I am choosing to ignore.

I will do the green drinks, I will eat healthy most of the time, and I will keep my weight down. Occasionally, though, I want a cheese biscuit or six, lard and all.

For more information, check out my book, Surviving Triple-Negative Breast Cancer.  You can get a free signed copy just by donating $25 to this site.  Click the Donate button on the right to donate through PayPal.   You'll then get an email from me asking how you want your book signed and where you want it sent.  Or you can buy the book directly without a donation.  Thanks!  And hugs.