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People with hereditary metastatic breast cancer have treatment options and special considerations that are different from people with non-hereditary, or earlier
Immunotherapy for Triple Negative Breast Cancer: The FDA approved the agent atezolizumab to be used in combination with the chemotherapy drug nab–paclitaxel (Abraxane) for women with locally advanced or metastatic triple-negative breast cancer that cannot be treated surgically and whose tumors are positive for a protein called PD-L1. The FDA also approved a companion diagnostic test called the VENTANA PD-L1 (SP142) Assay to identify patients with triple-negative breast cancer who are candidates for treatment with this immunotherapy–chemotherapy combination. Although this is not specifically a treatment for women with hereditary breast cancer, TNBC is particularly common in women with a BRCA1 mutation.
Participation in treatment clinical trials: Some research studies are exploring new treatments to specifically to treat hereditary
metastatic breast cancer. Using our Research Search Tool, you can find clinical trials enrolling patients with hereditary metastatic breast cancer.
Choice of chemotherapy: The Triple-Negative Breast Cancer Trial (TNT) compared the platinum-based drug carboplatin to the drug docetaxel as first line treatment in 376 patients with
metastatic triple-negative breast cancer and/or with a mutation in BRCA1 or BRCA2. (Patients with BRCA mutations and ER/PR-positive breast cancer also were included in this study.) When researchers compared the two drugs in all patients, the response rate was similar for the two chemotherapies. However, when they examined the results for the 43 patients who had mutations in either BRCA1 or BRCA2, they found that 68.0% of carriers responded to carboplatin as compared with 33.3% of carriers who received docetaxel. The results of this study show the benefit of BRCA testing patients with advanced triple negative breast cancer. Those who test positive for a BRCA mutation may benefit from carboplatin over docetaxel.