In the world, women are diagnosed with breast cancer more often than any other cancer. A severe form of breast cancer known as Triple Negative Breast Cancer is caused by the absence of all three receptors.

Triple negative breast cancer (TNBC) is an assertive malignancy with few relevant targets, making treatment a challenge for a long time. In contrast to other subtypes of breast cancer (BC), it is frequently detected at an earlier age and carries a worse prognosis, a median overall survival (OS) of less than two years, in the case of a metastatic relapse. So, after tumor excision, complete therapeutic regimens have been developed to reduce the chance of recurrence.

The most effective treatment for TNBC in its early stages is currently polychemotherapy. In order to assess tumor sensitivity and adjust post-operative systemic medication accordingly, it is usually given prior to surgery. Adjuvant capecitabine is highly effective because individuals who have residual illness following neoadjuvant chemotherapy are more likely to have a recurrence. Conversely, even though the risk of relapse is still clinically considerable, patients who obtain pathological complete response (pCR) during surgery should only have follow-up therapy.

Not a single unique medicine has been studied in the previous few decades to improve the prognosis of early Triple Negative Breast Cancer, with the exception of adjuvant olaparib, which was recently licensed for use in a subset of high-risk TNBC patients who have pathogenic mutations in either the BRCA1 or BRCA2 genes. However, the advent of cancer immunotherapy is changing how the disease is treated.

 

Static Data on TNBC

 

According to the Global Cancer Statistics 2020, 2,315,000 were females newly diagnosed with breast cancer but 684999 died of this disease. It is estimated that 1 percent of all the diagnosed diseases in the USA and the whole world were of breast cancer, and 7.5 million of the women who were diagnosed in the preceding five years were still alive.

Currently, breast cancer is the most common type of cancer that is experienced all over the world. Specific receptors for progestogen and estrogen are absent in Triple Negative Breast Cancer along with HER2 amplification of this aggressive type of breast cancer. It contributes to 15-25% of all cases of the disease affecting the breast. TAMs, stromal fibroblasts, connective tissue, ECM, VEGF, TILs, and cytokines that support tumor cell proliferation and invasion are immunological TMEs of the tumor. This TME is involved in two capacities for the growth, dissemination, and metastasis of tumors.

 

Causes of Triple Negative Breast Cancer

 

While the exact causes of Triple Negative Breast Cancer have not yet been established, attempts are being made in this direction. It is assumed to be initiated by a mutation of the tumor suppressor gene known as BRCA1. A protein that prevents the growth of cancer cells is often encoded by the BRCA1 gene. The BRCA1 gene, however, is mutated, which increases the body’s vulnerability to cancer by preventing the gene from operating correctly.

 

Symptoms

• An additional lump or bulk.
• Breast secretions that aren’t milk-related.
• Partial or total breast edema is possible.
• Red, thick, peeling, or dry breast skin.
• Nipple or breast discomfort.
• There are folds in the epidermis.
• The inward twisting of the nipple is called nipple retraction.
• Enlarged lymph nodes. The cause of this pain is breast cancer that has progressed to the lymph nodes under your arm or around your collarbone.

Diagnosis

CT scan, also known as PET scan.

Ultrasound.

MRI

 

Immunotherapy against Triple Negative Breast Cancer

 

Immunotherapy is a generic health treatment whose purpose is to enhance the immune system either actively by the use of vaccines or passively by the use of antibodies or other immunological enhancers.

Immunotherapy has thus brought a great improvement in the management of breast cancer, especially in cases of HER2 positive. Regardless of the disease stage, patients with this type of breast cancer should receive anti-HER2 monoclonal antibody trastuzumab, which increases effectiveness and decreases toxicity. After it is proved that trastuzumab can work, the scientific community is looking at immunotherapies for treating Triple Negative Breast Cancer and other definitions of breast malignancy.

The applicants with Triple Negative Breast Cancer undergo treatment to shrink the size of the tumors before the surgeon intervenes. Immunotherapy is among the preoperative treatments that go after cancer by stimulating the body’s immune system to annihilate it.

Immunotherapy is still our only choice for TNBC. Unfortunately, the response rate to immunotherapy alone is about 20% to 30% of patients. At the cost of considerable patient harm, responsiveness is increased by 60% when taken in conjunction with chemotherapy.

Clinical research examined the possibility of whether the immunotherapy that was delivered in company with radiation therapy could improve the response of the patient. The experiment entailed a look at the sample of tumors of thirty-four patients diagnosed with TNBC.

Patients were provided biopsies for the baseline, one immunotherapy session, radiation after immunotherapy, and one immunotherapy session again. They later autopsied the tissues that had been sampled by the medical practitioners. This was done to indicate what the medical practitioners saw when they carried out a biopsy on the patients.

To identify the certain types of immune and cancer cells in each tumor, single-cell genomic profiling was used. They also considered the intracellular localization of proteins that are produced by cells to find out more about the behaviors of cells that constitute the body.

 

Other forms of immunotherapy

 

Vaccination can be another approach to increase the activity of antitumoral immunity. As tumor-associated antigens (TAAs) are self-antigens any immune cells that identify them as such are usually eliminated during maturation hence TAAs have been used historically in cancer vaccines. Moreover, immunosuppressive features of the tumor microenvironment become another issue.

Efforts have been made to solve these problems by using vaccination along with the checkpoint inhibitors or utilization instead of TAAs the neoantigens. This has resulted in the design of several therapeutic vaccination which allows for long immunity, safety, and scalability to treat different forms of cancers. The findings that relate to the enhanced immunogenicity of Triple Negative Breast Cancer expand the list of potentially usable directions – checkpoint inhibitors, vaccines, ADCs, and cellular therapies.

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