Chemotherapy, radiation therapy, and surgery may not soon be among the only methods to treat this aggressive type of breast cancer anymore. As researchers are on the verge of a breakthrough, Petra Rietschel, MD still champions early detection.
By Kevin Hewston
For most women, a diagnosis of triple-negative breast cancer can be quite scary. This type of breast cancer lacks three receptors known to fuel most breast cancers. Therefore, it does not respond well to treatments designed to target these receptors. The cancer also is more likely to spread beyond the breast and to return after treatment, especially in early years. Studies show women don’t typically survive beyond an average of five years with the disease; its mortality rate is quite high.
But there is hope in combating this rare but aggressive and virulent form of breast cancer. Researchers at the Virginia Commonwealth University are testing whether the cancer responds to drugs used to combat other cancers. Using insight into the behavior of the disease, they think that two medications in particular will be especially useful in attacking the cancer. Almost all cancers contain a mutation of a gene called tumor protein 53 (TP53).
Perhaps the reason that triple-negative breast cancers are so invasive is due to the apparent absence of TP53-encoded protein p53. The deficiency of the protein encoded by the gene causes cancer cells to wildly spawn and metastasize out of control. In a recent article in the Richmond Times-Dispatch, lead researcher Dr. Andrew Poklepovic explains it this way: “Printing presses…going with no editors, they are just churning through and dividing and there’s no breaks on the system to say, ‘Stop, let’s make sure everything is correct before we go through cell division.’” He, like Petra Rietschel, MD, is an oncologist. He practices at the University’s Massey Cancer Center, where the study is being conducted.
Autophagy, literally “self-eating,” is a naturally occurring process in the life of a cell designed to generate energy when proteins are scarce. But when drugsPemetrexed and Sorafenib are thrown into the mix together, the cell kills itself as autophagy speeds up.Pemetrexed is an approved chemotherapy drug for lung cancer, while Sorafenib is used to treat kidney and liver cancer.A better understanding of p53s role in autophagy, as shown through this trail, may lead to more effective breast cancer treatments. Rather than blasting cells indiscriminately through present chemotherapy, for instance, future treatments would be tailored to genes like TP53.
Until then, Petra Rietschel, MD advises women to get mammograms in their 20s—contrary to popular belief. Why? Triple-negative breast cancer often affects young women, and late detection can be deadly.
About: Petra Rietschel, MD, is board-certified to practice medical oncology, hematology, and internal medicine. She works at the Montefiore-Einstein Center for Cancer Care in the Bronx, NY in addition to teaching and directing research efforts.