Treating Triple-Negative Breast Cancer
- Pittsburgh reporter Cara Sapida, 38, was diagnosed with triple-negative breast cancer after finding a lump in her breast while stretching.
- Thankfully her immunotherapy, chemotherapy other drug treatments and surgery were successful, and she remains cancer-free today.
- Triple-negative breast cancer is one of the most aggressive forms of the disease. The triple-negative distinction means the cancer does not have any of the main drivers of breast cancer the estrogen receptor, the progesterone receptor and the HER2 receptor – making it difficult to treat.
- There are several options for people with triple-negative breast cancer, including surgery, chemotherapy, radiation, immunotherapy and an antibody-drug conjugate.
- Adding immunotherapy Keytruda (pembrolizumab) to combination chemotherapy before surgery increases chances of living free of breast cancer.
- Antibody-drug conjugate Trodelvy (sacituzumab govitecan) was shown to improve progression-free survival and overall survival in 2021.
The reporter with WPXI in Pittsburgh might have first felt a breast cancer symptom when she felt a pain in her armpit back in 2019. After seeing her doctor and being referred for a mammogram, Sapida was told she likely had nothing to worry about.
The gynecologist “wasn't overly concerned,” Sapida said, but she referred Sapida for an ultrasound “just to be safe.” After the ultrasound and a follow-up biopsy, Sapida was diagnosed with stage 2 triple-negative breast cancer.
Triple-negative breast cancer is one of the most aggressive forms of the disease. It does not have any of the main drivers of breast cancer: the estrogen receptor, the progesterone receptor, and the HER2 receptor. Because of this, the cancer doesn't respond to any therapies that target those receptors, making it difficult to treat.
Visit SurvivorNet's Breast Cancer resource center for expert information on treating Triple-Negative Breast Cancer.
To treat her aggressive cancer, Sapida enrolled in a clinical trial that allowed her to get an immunotherapy drug for 12 weeks alongside chemotherapy. After that, she had four more drug treatments and a double mastectomy the removal of all her breast tissue.
Thankfully, her treatments were successful, and she remains cancer-free today. For the sake of educating others, she’s shared her journey via her book "Not the Breast Year of My Life."
"A lot of people were surprised when they read the book that they're crying one minute and laughing in the next," she said. "It is because this experience is so overwhelming and so ridiculous. Sometimes you just have to laugh to get through it."
For help finding a clinical trial that made be right for you or a loved one, try our easy-to-use Clinical Trial Finder that helps you discover studies based on a few simple questions about your disease and location.
Treating Triple-Negative Breast Cancer
Since triple-negative breast cancer does not have any of the main drivers if the disease, hormonal therapy would be ineffective and therapies meant to target HER2 protein would be ineffective. So, treating triple-negative breast cancer can be tricky.
However, thankfully, there are still good options.
RELATED: How to Treat Triple-Negative Breast Cancer: Keytruda Shows Promising Boost in Survival
For starters, people with triple-negative breast cancer often need to have their lump removed via a lumpectomy or mastectomy. But, according to medical oncologist Dr. Elizabeth Comen of Memorial Sloan Kettering Cancer Center, "the most important way we would treat this cancer for many patients is with chemotherapy."
Oftentimes, these patients are treated with a combination of chemotherapies.
"It's really important to talk to your doctor about what chemotherapy options are available," she said.
On top of standard chemotherapies, patients may also have the option of things like radiation therapy, immunotherapy (which uses the body’s own immune system to fight cancer) and other drugs.
The First Immunotherapy Approved For Breast Cancer Hope For Triple Negative Breast Cancer
In 2021, the FDA approved the immunotherapy drug Keytruda (generic name pembrolizumab) for the treatment of early-stage triple-negative breast cancer. This therapy had already been used in treating other cancers, but doctors said the FDA approval was a potentially paradigm-shifting advancement in breast cancer treatment.
According to breast oncologist Dr. Sylvia Adams, director of the Breast Cancer Center at NYU Langone Health's Perlmutter Cancer Center, adding Keytruda to combination chemotherapy before surgery increases chances of living free of breast cancer. Dr. Adams was one of the researchers involved in the trial that led to Keytruda’s FDA approval.
"It changes the standard of care and should be discussed with all patients who are diagnosed with stage 2-3 TNBC," she told SurvivorNet. "Yes, it's a game-changer, though there is much more to be learned."
Additionally, the drug Trodelvy (generic name sacituzumab govitecan) was approved as the first treatment for metastatic triple-negative breast cancer and shown to improve progression-free survival and overall survival in 2021.
This drug is an antibody-drug conjugate meaning it has an antibody attached to an anti-cancer drug that delivers the drug directly to the cancer cells when Trodelvy enters the bloodstream via IV infusion. Delivering the drug this way means it can reach the cancer cells with minimal effects on healthy cells.
"These medications actually use an antibody to find the tumor and then bring chemotherapy (the anti-cancer drug) directly to the them," Dr. Adams said.
"And, being a smart bomb, you have less toxicity in the entire body."
Overall, know that there are treatment options no matter what type or stage of breast cancer you’ve been diagnosed with. Make sure you have a thorough conversation with your doctor about an individualized treatment plan so you can feel confident you’re getting the best care possible.
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