Therapeutic landscape of metaplastic breast cancer
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Published on: March 20, 2020
Abstract:
Metaplastic breast carcinomas (MPBC) are rare, aggressive and relatively chemorefractory tumors with a high unmet need. While most are "triple negative" and lack expression of estrogen, progesterone and HER2 receptors, MPBC are associated with worse outcomes compared to conventional triple negative invasive tumors. MPBCs are genetically heterogeneous and harbor somatic mutations, most frequently in TP53, PIK3CA and PTEN, with emerging studies suggesting a role for novel targeted therapies. These tumors have also been associated with overexpression of PD-L1 and tumor-infiltrating lymphocytes suggesting an endogenous immune response and therefore a rationale for treatment with immunotherapies. Here, we focus on therapeutic options for this difficult to treat breast cancer subtype and encourage physicians to consider targeted therapies/immunotherapies as part of ongoing clinical trials.
Insights
Metaplastic breast carcinomas (MPBC) are rare, aggressive cancers. Novel targeted therapies and immunotherapies show promise for treating this challenging breast cancer subtype.
Area of Science:
- Oncology
- Genetics
- Immunology
Background:
- Metaplastic breast carcinomas (MPBC) are rare, aggressive tumors.
- MPBCs are often triple-negative and associated with poorer outcomes than conventional triple-negative breast cancers.
- These tumors exhibit genetic heterogeneity with frequent TP53, PIK3CA, and PTEN mutations.
Purpose of the Study:
- To review therapeutic options for metaplastic breast carcinoma.
- To highlight the potential of targeted therapies and immunotherapies for MPBC.
- To encourage clinical trial enrollment for MPBC patients.
Main Methods:
- Literature review of MPBC therapeutic strategies.
- Analysis of genetic mutations and immune markers in MPBC.
- Evaluation of targeted therapy and immunotherapy approaches.
Main Results:
- MPBCs are genetically diverse, with actionable mutations identified.
- PD-L1 overexpression and tumor-infiltrating lymphocytes suggest immunotherapeutic potential.
- Chemotherapy resistance is a significant challenge in MPBC treatment.
Conclusions:
- Targeted therapies and immunotherapies represent promising avenues for MPBC treatment.
- Clinical trials are crucial for advancing care for this rare breast cancer subtype.
- A multidisciplinary approach is essential for managing MPBC.
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