You probably know by now that not all cancers are the same and different treatments are needed for different types of breast cancer. But did you know that a team of Malaysian scientists and doctors are developing a new way to accurately choose the right treatment for Malaysian breast cancer patients by testing cancer genes?
The scientists at Cancer Research Malaysia (CRMY) found a new way to identify breast cancer patients with a cancer gene profile that may predict a patient’s ability to respond to a new drug [called talazoparib]. Now, working in partnership with doctors at University Malaya, Pantai Hospital Kuala Lumpur and Hospital Sultan Ismail in Johor Baru, the team has embarked on clinical trial to assess whether this method helps doctors know with greater accuracy whether patients will respond to talazoparib.
Talazoparib is part of a family of new drugs called poly (ADP-ribose) polymerase (PARP) inhibitors. PARP inhibitors are particularly active among patients who inherited faulty breast cancer genes (BRCA1 and BRCA2 genes) and for these patients, PARP inhibitors can slow the growth of cancers very effectively, enabling women with even aggressive triple negative breast cancers to survive longer. Unfortunately, at the moment, these drugs only seem to work on patients with faulty genes, but there is no accurate way to identify breast cancer patients who do not have faulty BRCA genes who may also survive longer with this new therapy. And this is where the method developed by CRMY scientists come in – we developed a method which seems to accurately identify such women. But this needs to be tested before it can be applied more widely.
Hence the TENOR Trial! The goal of the TENOR study is to test whether women with aggressive triple negative breast cancer will survive longer when given the PARP inhibitor.
Currently, this study has been successfully initiated at three local hospitals: two patients have been enrolled and the aim is to recruit 55 patients in the coming months.
The symptoms of triple negative breast cancer are similar to other breast cancer types.
Symptoms can include:
- a new lump or thickening in your breast or armpit
- a change in size, shape or feel of your breast
- skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
- fluid leaking from the nipple in a woman who isn’t pregnant or breast feeding
- changes in the position of nipple
Prognosis and Treatment
Triple-negative breast cancer is a difficult diagnosis to face. Because your tumour doesn’t have the receptors that typically fuel the growth of breast cancers, treatment options for this particular type of cancer are limited. Coping with triple-negative breast cancer, then, involves not only navigating the physical and practical aspects of treatment but some unique emotional ones that come with learning more about what might work–and what simply can’t.
Unlike other kinds of breast cancer, triple-negative breast cancer doesn’t have estrogen receptors, progesterone receptors, or HER2 receptors (the proteins that fuel the growth of breast cancer). The term “triple-negative” means breast cancer is estrogen-negative, progesterone-negative and HER2-negative.
Triple-negative breast cancers tend to be more aggressive and spread more quickly than other types of breast cancer, making them challenging to treat. Chemotherapy is the main treatment for TNBC. While targeted therapy given during or after active treatment can help prevent recurrence in other forms of breast cancer, this is not the case for TNBC. Treatments that target specific receptors won’t work for cancers where the receptors are absent, as in the case of triple-negative breast cancer.
As such, many common drugs used to treat breast cancer, such as tamoxifen and Herceptin (trastuzumab), do not effectively treat TNBC. Consequently, people diagnosed with triple-negative breast cancer often fear cancer recurrence following the end of active treatment. Research has shown that the risk of recurrence is highest in the first five years after diagnosis. New discoveries such as immunotherapy are starting to change the previous beliefs that TNBC is untreatable.
Getting Support
Special thanks to the research participants in the MyBrCa study who consented to us using their tumor samples to conduct genomics research that led to the development of this new method. Plus, we had collaborators in the UK from the Caldas Lab in Cambridge who helped us to do the genomics sequencing that enabled this study. We also had a lot of help from doctors and staff at SJMC and UM who help us to collect and process samples, as well as former members of the team who helped with the tumor sequencing project.
As for cancer survivors or cancer caregivers, no one will understand what you’re going through better than someone who has been in your shoes. At any point of time, should you or your loved ones need support, you can connect with our team at any one of our Patient Navigation Centres (PNP) located at Hospital Tengku Ampuan Rahimah Klang, Hospital Tuanku Ja’afar Seremban, Hospital Queen Elizabeth II Sabah and Hospital Umum Sarawak.
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Breast cancer is the leading cause of death in women and has surpassed lung cancer as the most commonly diagnosed cancer worldwide. According to the latest statistics by World Health Organisation, there are estimated to be 8,418 new cases of breast cancer and 3,503 deaths in Malaysia in 2020.
Content References/Citation/Source:
National Library of Medicine & Division of Cancer Prevention and Control
How Triple negative breast cancer is treated by Jean Campbell, July 21, 2021
Centers for Disease Control and Prevention & American Cancer Society
Cancer Research Malaysia Blog 
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