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The second half of SABCS featured more TNBC-specific research dealing with treatment, recurrence, and brain metastasis:

Carboplatin
In a mentor session on Friday evening, Dr. Virginia Kaklamani spoke to the importance of the research presented this week on the use of carboplatin to treat TNBC. Although the benefits of carboplatin have been up for debate for many years, research presented at this SABCS showed that the use of carboplatin was beneficial and improved outcomes for women diagnosed with TNBC. For more aggressive cancers like TNBC, we now know that carboplatin can improve outcomes and likely helps decrease the rate of recurrence. 

Using ctDNA to detect recurrence 
In the wake of a last year’s research insights around circulating tumor DNA (ctDNA), new tests are now available to test ctDNA regularly after treatment. Cancer cells have their own DNA. When those cells exist in a body, traces of the cancer’s specific DNA will shed or fragment and end up circulating in the bloodstream (called circulating tumor DNA). Often, ctDNA shows up in the bloodstream before imaging could ever identify a tumor. As a result, tests currently on the market can test for ctDNA every year after treatment in order to detect a recurrence as early as possible. “Detectable ctDNA post-treatment is a strong predictor of breast cancer recurrence,” according to Dr. Telli. If we can detect a recurrence earlier, we can also start treatment earlier, improving outcomes for TNBC patients in particular. 

Potential future treatment for brain metastases in ER- metastatic breast cancer
We know that younger women diagnosed with breast cancer have an increased risk of brain metastases, but research presented at SABCS this year suggests that estrogen and the immune system may both have something to do with it. A seminar entitled “Estradiol represses anti-tumoral immune response to promote progressions of ER- brain metastasis” found that pre-menopausal levels of estradiol (a type of estrogen) promote brain metastasis in triple negative breast cancer. The study found that estradiol suppression can decrease metastasis to the brain in TNBC patients, but its effectiveness is dependent on a primed and fully functional immune system. Estradiol suppression needs more research, but this study suggests that it may be used in combination with the standard stereotactic radiosurgery (SRS) for brain metastasis in younger women diagnosed with TNBC. 

From all of the research we saw this week, we know that we can look forward to much more clinical research and eventual treatment options coming down the pipeline in the next few years. Join us in 2023 for the newest results, research, and insights from SABCS!

SABCS 2022 kicked off with conversations around diversity in breast cancer advocacy, education, research, and resources. Especially for TNBC, which impacts Black women at 3x the rate, these conversations are integral to finding new, diverse treatment options for all women!

Diversity In Clinical Trials
Monday featured Black Wo(men) Speak Symposium—an event hosted by the Metastatic Breast Cancer Alliance to educate the community-at-large about the urgent need for greater diversity in clinical trials. The symposium shared data gathered by TOUCH, The Black Breast Cancer Alliance, Carrie’s TOUCH, For the Breast of Us, and the MBC Alliance in order to better inform its audience of the current barriers to clinical trial participation, to inspire greater trust in the healthcare system to provide equitable care regardless of race, and to ensure access to clinical trials to a population that is more representative of all patients. The Symposium also aimed to empower the Black patient community to speak up regarding clinical trial options. Later that evening, TOUCHBBCA hosted a When We Tri(al) community event to bring together key stakeholders in the local Black community to discuss the state of Black Breast Cancer in San Antonio. TNBC was at the forefront of the conversation, which sparked solutions around grassroots community organizing. Look for a When We Tri(al) event near you at www.whenwetrial.org.  

As we all read, listen, and watch the research being presented this week, it’s also important to know what exactly we’re looking for!

What are clinical trial endpoints?
Clinical trial endpoints are the outcomes that research studies use to measure how well their new treatments are working. Different interventions and treatments measure different types of data. Knowing what the following endpoints mean and their shorthand can help you understand the results of a clinical trial:

• Disease Free Survival (DFS): the amount of time between treatment and relapse, often used around surgery
• Progression Free Survival (PFS): the amount of time between treatment and progression—or worsening— of the disease
• Response Rate (RR): the percent of participants whose cancer gets smaller or disappears after treatment
• Overall Survival (OS): how long the participant survives post treatment
• Quality of Life (QoL): how a treatment impacts any and all of the symptoms related to the cancer, such as pain, nausea, etc. 

Check back to keep abreast of takeaways from SABCS 2022!