Triple Negative Breast Cancer: Trodelvy Magic Bullet


PITTSBURGH, Pa. (Ivanhoe Newswire)— About 15 percent of all women diagnosed with breast cancer have triple negative breast cancer, meaning drugs that target estrogen, progesterone, and HER-2 protein—won’t work. In the past, if the cancer returned, patients have had very few options. More on a newly approved drug that is stopping the cancer in its tracks.

Jane Ellen Keenan is a cancer warrior, battling triple negative breast cancer since 2013. She had six months of chemo, and surgery. The cancer was gone … for a time.

“Because it’s a triple negative, the recurrence rate is fairly high and two years later…” shared Jane Ellen Keenan.

The cancer had returned to her lung. Her next therapy caused her wrists to swell. Another caused painful sores on her feet.

Jane recalled, “When I talked to Dr. Brufsky, I said, okay, that one didn’t work. What else you have?”

After two failed therapies, Jane qualified for a drug called Trodelvy. It’s what doctors call an antibody- drug conjugate.

“And what that means is that we take an antibody, which binds to a protein on the cancer cell, and we attach chemotherapy to it. It’s kind of like a magic bullet,” described Adam Brufsky, MD, PhD, director of the Comprehensive Breast Cancer Center at UPMC Hillman Cancer Center.

(Read Full Interview)

Trodelvy is an infusion. Jane Ellen receives the drug on days one and eight of a 21-day cycle. For now, it’s stopped the cancer from growing.

Dr Brufsky explained, “We as docs know that once you’ve been through a lot of chemotherapy for metastatic triple negative breast cancer, you know, you don’t do very well, but these people did, a lot of them did, incredibly well!”

Dr. Brufsky says Trodelvy is not a cure, but it gives patients quality of life. A retired veterinarian, Jane Ellen says she takes her cues from the animals she spent a career treating.

“They do not complain. They just do what they need to do and move forward. And that’s what you have to do,” Jane shared.

Doctor Brufsky says Trodelvy also has what he called a bystander effect, meaning the drug is released not only into the cancer cell, but also killed cancer cells outside the target. He says the side effects include some digestive issues, low white blood cell count, making patients more susceptible to infection, and in the case of some patients like Jane Ellen—hair loss.

Contributors to this news report include: Cyndy McGrath, Executive & Field Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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BACKGROUND: Triple negative breast cancer is cancer that tests negative for estrogen and progesterone receptors, and excess HER2 protein. This means the growth of the cancer is not fed by the hormones estrogen and progesterone, or by the HER2 protein. Therefore, triple-negative breast cancer does not respond to hormonal therapy medicines or medicines that target HER2 protein receptors. About 10-20% of breast cancers are triple negative. For doctors and researchers, there is interest in finding new medications that can treat this kind of breast cancer. Studies are trying to find out whether certain medications can interfere with the processes that cause triple-negative breast cancer to grow.


DIAGNOSIS AND CURRENT TREATMENTS:  Triple negative breast cancer is more likely to be diagnosed in people younger than age 50. Black women and Hispanic women are more likely to be diagnosed, whereas Asian and white women are less likely to be diagnosed. About 70% of breast cancers diagnosed in people with an inherited BRCA mutation, particularly BRCA1, are triple negative. Treatment can consist of a combination of surgery, radiation therapy, and chemotherapy. When triple negative breast cancer is treated with chemotherapy before surgery, called neoadjuvant chemotherapy, and there is a pathologic complete response, disease-free survival and overall survival are better. PARP inhibitors, such as Lynparza and Talzenna, have been approved to treat advanced-stage HER2-negative breast cancer in people with a BRCA1 or BRCA2 mutation. Finally, immunotherapy medicines work by helping your immune system work harder or smarter to attack cancer cells.


DRUG SHOWS IMPROVED OUTCOME: An immune targeted therapy medicine, known as Trodelvy, has shown to offer better progression-free survival and overall survival for people diagnosed with metastatic triple negative breast cancer that had previously been treated with chemotherapy. The study included 529 people diagnosed with metastatic triple negative breast cancer that had grown after being treated with two or more chemotherapy regimens. The people were randomly assigned to one of two treatments, either Trodelvy (235 people), or their doctor’s choice of one of four chemotherapy medicines, and received treatment until the cancer grew or unacceptable side effects developed. The results showed that more of the cancers responded to Trodelvy compared to chemotherapy. Aditya Bardia, Director of Precision Medicine at the Center for Breast Cancer at Massachusetts General Hospital Cancer Center, said, “The phase III ASCENT trial is the first phase III study to demonstrate a significant improvement in efficacy with a first-in-class Trop-2-directed antibody-drug conjugate compared with standard chemotherapy.”






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Doctor Q and A

Read the entire Doctor Q&A for Adam Brufsky, MD, PhD, director of the Comprehensive Breast Cancer Center

Read the entire Q&A