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Quote on lack of chemo TNBC efficacy

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Topic: Quote on lack of chemo TNBC efficacy

Posted By: AC and JC
Subject: Quote on lack of chemo TNBC efficacy
Date Posted: May 14 2009 at 5:27pm

Hey folks:

I am under the (perhaps mistaken) impression that while TNBC lacks targeted therapies, the available chemo regimens are actually relatively quite effective (even more so than on non-TN cancers).

Then I saw this quote today from Dr. Ruth O'Reagan at Emory University's Winship Cancer Institute:

"Some triple negative breast cancers respond very well to chemotherapy, like Karen's did. But others that unfortunately do not. And the majority of triple negative breast cancers do not respond very well to chemotherapy, which is another reason why they have a poor prognosis."

Full story is http://www.publicbroadcasting.net/wabe/news.newsmain/article/0/1/1505413/Atlanta/Treating - here .

Reading this leads me to believe that chemo does not work on most cases of TNBC, which is contrary to my previous thinking. Does anyone know what statistics/studies Dr. O'Reagan is referring to when forming/stating this position?

Thanks,
Jason

Replies:

Posted By: dmwolf
Date Posted: May 14 2009 at 7:50pm

My understanding is that 1) TN responds much better to chemo than, say, ER+ breast cancer, but 2) TN is much more likely to metastasize than ER+ cancer, and when it does recurrence happens sooner. It's strange - you look at the ER+ cancer response rates, and they are terrible - very, very low. But recurrence rates for these women, even ones with big tumors and positive nodes, are small. Responding to chemo is not the same thing as wiping out every last cancer cell in a person's body. Only pCR (pathologic complete response) is really likely to do that, and that happens in the neighborhood of 40%.

Chemo is the way to go for TN. It is no guarantee, but it increases the odds by plenty.

-Denise

-------------
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.

Posted By: Cebo
Date Posted: May 15 2009 at 4:02am

Wow, that is a bombshell if she is right. Her opinion id definitely against the majority - if not all - of the opinions I have read. I hope anhd pray she is wrong.

-------------
Sister DX'ed 11/08
Lumpectomy & SN biopsy 12/08
1.1 cm tumor, node neg (0/2)
Stage 1
DD A/C x 4, Taxol x 4, completed 4/17/09
33 rads (incl 8 boost), completed 6/22/09

Posted By: trip2
Date Posted: May 15 2009 at 5:31am

I'm sorry I myself posted this this morning not seeing your thread.

This doc was so blunt, it is concerning.

Denise of course chemo is our best shot but recently in the studies they are learning that some subtypes might do better on a particular chemo or if they have a brca 1 mutation they may need a different chemo. I have read just recently brca 1 may be Taxane resistant.

So getting the right chemo might change the numbers for the better.

Getting the wrong chemo might not be so good.

This doc is not a fly by night doc, I want to know why she feels the way she does. I need facts, that's me.

-------------
Stage 2 2003
Stage 1 2007
BRCA 1+

Posted By: sharon rereg
Date Posted: May 15 2009 at 9:43am

Didn't we just have an article posted that said TNs had a 22% of pCR from the standard chemo while ER+s had half that? I know we'd rather have it 100%, but 22% is a fighting chance and worth trying for.

Sharon

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dx 03/05 multi focal TN, lymph involvement.BRCA- 4 dd AC, 4 biweekely taxol, bil mast 08/05, 38 rads. NED

Posted By: dmayes
Date Posted: May 15 2009 at 1:40pm

Gosh,

Can anyone share the brca +1 article. I am getting gentics tsdting done but just started chemo this monday. Might need to have a chat with onc on next visit - he doubts I will be positive in the genetics testing - as I am the first in my family, but still - this makes me worried.

Debs