“Roche Holding AG will skip a mid-stage study of an experimental immunotherapy for breast cancer and proceed directly to a phase 3 trial later this year.
“The Swiss company will study MPDL3280A for triple-negative breast cancer, which is currently treated mostly with chemotherapy, spokeswoman Holli Dickson said in a phone interview. The drug will be tested in combination with chemotherapy.
“The company will present results from an early-stage study of the drug at a cancer meeting in Philadelphia on April 20. Roche is competing with Merck & Co. to develop a drug for a segment of the breast cancer market that may reach as much as $5 billion in peak sales, according to Goldman Sachs Group Inc. analysts.”
“At Ricki Fairley’s annual check-up in 2012, doctors found a tiny lump. She was diagnosed with triple negative breast cancer, a less common and more aggressive form of the disease that has very few treatment options. Approximately 15 percent of all breast cancer cases are categorized as triple negative.
“Triple negative breast cancer can be effectively treated if the disease is caught early, and Fairley, now 58 years old, is living proof. She underwent a long course of aggressive chemotherapy and radiation and is now doing well.
“Triple negative is one of four subtypes of breast cancer, and a new report emphasizes how important it is for doctors to identify the risks and treatments for each. For example, triple negative cancers do not respond to certain hormonal therapies that can help other women.
“The nationwide data — published in the Journal of the National Cancer Institute and co-authored by the American Association of Central Cancer Registries, the American Cancer Society, the Centers for Disease Control and Prevention, and the National Cancer Institute at the National Institutes of Health — may help doctors identify which patients are at most risk for each type of breast cancer and which treatments may be most effective.”
“Australian researchers have found that so-called ‘triple-negative breast cancers’ are two distinct diseases that likely originate from different cell types. This helps explain why survival prospects for women with the diagnosis tend to be either very good or very bad.
“The Sydney-based research team has found a gene that drives the aggressive disease, and hopes to find a way to ‘switch it off’.
“The aggressive form of triple-negative breast cancer appears to arise from stem cells, while the more benign form appears to arise from specialised cells.
“Stem cells have many of the same features as cancers. They are plastic and flexible, and have the ability to proliferate and spread into other tissues – deadly traits in cancers.”
The gist: New research shows that it may soon be possible to measure how aggressive a patient’s triple-negative breast cancer might be. Patients with aggressive cancer might benefit from different treatment approaches from those prescribed for patients with less aggressive cancer. The new technique looks at patterns of “DNA methylation” in a tumor. In DNA methylation, molecules called methyl groups become attached to DNA molecules in distinctive patterns. The new research shows that certain DNA methylation patterns can indicate whether a tumor is likely to be aggressive.
“Australian researchers have identified epigenetic ‘signatures’ that could help clinicians tell the difference between highly aggressive and more benign forms of triple-negative breast cancer.
“The new study, published in Nature Communications, compares the breast cancer DNA ‘methylome’ with that of healthy individuals. The methylome provides a new picture of the genome and shows how it is epigenetically ‘decorated’ with methyl groups, a process known as DNA ‘methylation’.
“The study reveals ‘distinct methylation patterns’ in the primary biopsy breast cancer cells indicating better or worse prognosis.
“Triple-negative breast cancers, which make up 15-20% of all breast cancers, lack any of the three receptors (oestrogen, progesterone or HER2) that would make them responsive to targeted drugs. Overall, patients have a higher risk of disease recurrence and shorter survival than those with other breast cancers.
“Triple-negative breast cancer patients tend to fall into two categories: those that succumb to their disease within 3-5 years, regardless of treatment; and those that remain disease free for longer than the average non-triple-negative breast cancer patient (at least 8 years post-diagnosis).”
The gist: Recent research shows that testing for BRCA1 and BRCA2 mutations might be useful for patients with triple-negative breast cancer, even if they have no family history of breast cancer.
“The high prevalence of deleterious mutations in predisposition genes in patients with triple-negative breast cancer unselected for family history suggests germline genetic testing for BRCA1 and BRCA2 mutations may be appropriate in this population, according to study results.
“However, further analyses of non-BRCA genes are needed to assess their utility in this setting, researchers wrote.
“Fergus J. Couch, PhD, of the department of laboratory medicine and pathology at Mayo Clinic in Rochester, Minn., and colleagues evaluated data from 1,824 women with triple-negative breast cancer who were enrolled on one of 12 studies. All women were unselected for family history of breast or ovarian cancer, and most were non-Hispanic white (97%). The median age of the population at diagnosis was 51 years (range, 22-93).”