Even Some Doctors Never Heard of It

It is a common misconception that those diagnosed with breast cancer all suffer from the same gene mutation—and therefore can receive the same treatment. But did you know that there are several sub-divisions of cancers that occur in the breast and that they all get blanketed under the umbrella of “breast cancer”?

For most people diagnosed with breast cancer—85 to 90%—have a mutation in one (or more) of three genes: mutated estrogen hormone receptor, mutated progesterone hormone receptor and/or mutated HER2 (human epidermal growth factor receptor 2). You can see in the pie chart (this page) that about 60% of women and men have mutations in estrogen and progesterone. You will also see that 25% of women and men have a mutation in HER2 (either solely or in combination to the estrogen and/or progesterone mutations). All of these types of mutations (luckily!) have multiple treatment options.

But what about that red section on the pie chart? What about that 10-15% of women who have what’s called Triple Negative Breast Cancer? What exactly does Triple Negative Breast Cancer (TNBC) mean and how is it treated?

TNBC is a blanket term for breast cancers that test negative for the three DNA receptors that are common among 85-90% of all breast cancer patients. Unlike most breast cancer patients, the cancer is not caused from a mutation in the “three usual suspects:” mutated estrogen hormone receptor, mutated progesterone hormone receptor and/or mutated HER2 (human epidermal growth factor receptor 2). Sometimes doctors can’t even tell WHAT type of cell mutation is causing the breast cancer.

Unfortunately, if you, or a loved one, has been diagnosed with TBNC, your prognosis now falls into a new gray area…a new dimension of body, breast and science.

TNBC makes up 10-15% of all breast cancer patients—and is more prevalent in women under 40 and African-American women. Unfortunately, doctors report that TNBC tends to be more aggressive. Common treatments used for other breast cancer patients (such as Herceptin, Taxoxifen and Armatase) do not work in TNBC patients. In addition, patients with TNBC have a 30% chance of a relapse (following the first 3-5 years of treatment). The common breast cancer gene mutations BRCA1and BRCA2, are found in only 5-15% of TNBC patients.

Unfortunately, TNBC patients sometimes just don’t respond to current breast cancer treatments. They also, in most cases, are not eligible for breast cancer alternative drugs/ treatment trials. This is because many breast cancer trials focus on the very receptors (estrogen, progesterone and HER2) that TNBC patients are not having issues with.

But (!), amazing new breakthroughs are happening everyday through research trials. Two particular TNBC research areas are looking especially promising. One cluster of trials is focusing on the receptors that repair the cells (instead of focusing on the mutated cells themselves)—these “repairmen” cells are referred to as PARP enzymes. The second area of research close to a breakthrough deals with “re-sensitizing” the cancer cells into responding to aromatase inhibitors (which are already FDA approved and commonly used). Both of these trial options are available to TNBC patients (and sometimes other cancer patients) and all of the trial and contact information is listed in the PARP article.
 

Where Do Dozer’s Fundraising Monies Go?

By Shannon Youngs

While Dozer the dog is busy raising funds for the University of Maryland’s Marlene and Stewart Greenebaum Cancer Center (UMMSGCC), the university’s cancer center is busy fighting for the cure of numerous cancers. Thanks to Dozer’s outreach, more people have become aware of the extensive cancer research developments (and exciting possibilities) that the University of Maryland (UM) has to offer.

Dozer has found himself among quite distinguished colleagues. Currently, the UMMSGCC is ranked as the #22 top cancer center in the nation (according to U.S. News and World Report 2011 publication). In addition, the National Cancer Institute (NCI) has just renewed its listing of UMMSGCC as a premier cancer center, for the 5th year in a row. The cancer center currently offers 215 clinical trials, often collaborating with other leading cancer centers across the country.
What makes UM and Dozer such a perfect match is that they both give hope to the “under dogs.” Just as Dozer himself was an “underdog,” the center places a strong emphasis on participation of underrepresented minorities in clinical research. About 36 percent of minority patients treated at the cancer center participate in a clinical trial, compared to a national average of about 1 percent. “African-Americans have a much higher death rate from cancer than white patients with the same disease, and we need to look at the underlying reasons. Their participation in clinical trials provides us with valuable information to better understand cancer in this community and to develop effective treatments,” says Kevin J. Cullen, M.D., the cancer center’s director and professor of medicine at the University of Maryland School of Medicine.

Key areas of research include cancer health disparities; cancer vaccines and tumor immunology; resistance of certain cancers to chemotherapy; HIV-related cancers; development of new cancer drugs and treatments; and the genetics of cancer—the role that certain genes play in how the disease develops.
A large portion of Dozer’s fundraising goes towards helping the “under dogs” of the “breast cancer world”— patients with triple-negative breast cancer (TNBC). Dozer helps fund TNBC trials and research for Dr. Angela H. Brodie. Brodie is an internationally recognized breast cancer researcher and professor who has pioneered the development of a class of drugs called aromatase inhibitors, which have become the standard of care for thousands of breast cancer patients worldwide. Dr. Brodie is looking at ways to reprogram resistant tumors—such as aggressive TNBCs—so that they respond to treatment with aromatase inhibitors.

Helping cancer “under dogs” one marathon-running, fund-raising paw at a time. I’m sure if Dozer (the “dog no one wanted”) could speak, he wouldn’t have it any other way.