Educational Information

Metastatic Triple Negative Breast Cancer Treatment Options

Metastatic Triple Negative Breast Cancer Treatment Options

National Breast Cancer Foundation partnered alongside CancerCoachLive to present an educational webinar titled, “Navigating Treatment and Support for Triple-Negative Breast Cancer.” Below is some of the information presented by CancerCoachLive’s team for patients, loved ones, and caregivers facing metastatic triple negative breast cancer. Click here to watch the entire webinar.

What is Triple Negative Breast Cancer (TNBC)?

Triple negative breast cancer is considered the most aggressive and hard-to-treat form of breast cancer. The term “triple-negative” comes from this type’s lack of three markers, or receptors, commonly found in other types of breast cancer. TNBC lacks receptors for:

  • Estrogen
  • Progesterone
  • HER-2

Since TNBC lacks these three receptors, the cancer is less likely to respond to hormone therapy, a common form of breast cancer treatment. However, chemotherapy, among other options, is still an effective option for the treatment of TNBC.

Read more about triple negative breast cancer and prognosis.

Treatment Options for Metastatic TNBC

Metastatic breast cancer (MBC) is classified as Stage 4 breast cancer. In MBC, the cancer has spread to other parts of the body, which usually includes the lungs, liver, bones, or brain. When TNBC spreads to other parts of the body, it is considered metastatic TNBC.

Although metastatic TNBC is not curable, it is usually treatable, with the focus being on quality of life for the patient. Several factors influence treatment selection for metastatic TNBC, including disease stage, histology (tissue structures), subtype, previous treatments, and patient preferences. The best treatment available is the one that is tailored to the patient’s specific disease, goals, tolerances, and quality of life.

Surgery and radiation are not primary treatments for metastatic TNBC—these treatment options are often used in early-stage disease. For metastatic TNBC, surgery and radiation are considered palliative options that may be used to shrink tumors to make them easier to treat.

Chemotherapy includes oral or IV medicines used to destroy cancer cells in order to shrink a tumor before or after surgery or after the tumor spreads.

Immunotherapy is a relatively new form of treatment for women with MBC. Immunotherapy helps the body’s own immune system fight the cancer. Pembrolizumab and atezolizumab are approved immunotherapy options for metastatic TNBC.

Targeted therapy is treatment directed towards specific markers. Targeted drugs often have less severe side effects than standard chemotherapy drugs. There are two types of targeted therapies currently available for TNBC: antibody-drug conjugates and PARP inhibitors.

  • Antibody-drug conjugates (ADCs) attach to chemotherapy drugs to deliver the chemotherapy directly to a specific protein which destroys cancer cells while sparing healthy cells. ADCs that are currently available for TNBC include sacituzumab govitecan and trastuzumab deruxtecan.
  • PARP inhibitors block cancer cells from copying themselves. They work best in tumors with certain genetic markers or mutations, like BRCA. There are currently two PARP inhibitors approved for TNBC: olaparib and talazoparib.

What are Metastatic TNBC Treatment Side Effects?

It’s important to have open discussions with your doctor and care team about how you may feel before, during, and after starting treatment.

Questions to ask your doctor or care team when discussing treatment plans:

  • What are my medication or treatment options?
  • How will this medication/treatment help me?
  • What are the side effects of this treatment?
  • Will taking this medication make anything worse?
  • Will I still be able to do my favorite activities or enjoy my favorite meals?

Some cancer treatment and medication side effects include:

  • Nausea or vomiting
  • Hair loss
  • Memory problems or trouble thinking
  • Pain
  • Infections

If you experience these or other side effects for an extended period of time, contact your care team.

Clinical Trials

A clinical trial is an approved research study that some doctors believe has a strong potential to improve standard treatments. Clinical trials are often used to learn if a new treatment is more effective than currently available care. There are new ways to treat TNBC being investigated and researched all the time. Clinical trials have many advantages, including:

  • Additional treatment option(s) if current treatments aren’t effective
  • Access to new medications before they’re widely available
  • Extra monitoring and check-ups from a care team while in the trial
  • Ability to help move research forward to help others

Check with your care team about the availability of clinical trials in your area.

As with all treatment options, each patient should work with their medical team to determine the best approach to treating their specific type and stage of breast cancer.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

This post has been produced in partnership with CancerCoachLive and MedLive and presented by Tiffany A. Traina, MD, FASCO; Sara Donahue, MPH, NP, AOCNP; and Jennifer Witt, RN, MSN, OCN, CBCN. The full webinar can be viewed here.

Publish Date: September 12, 2023

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