While physicians are looking to further subclassify TNBC to narrow treatment options, not all of these classifications are actionable in the clinic.
Physicians are looking for a way to further classify the tumors of patients with triple-negative breast cancer (TNBC), but some of the sub-classifications they have come up with are not actionable in the clinic yet, according to Adity Bardia, MD, MPH.
TNBC is difficult to classify into subgroups but finding a way to do so can help physicians narrow their treatment options, but there is not enough research to determine which treatment options should be used based on these subgroups. Bardia, attending physician of medical oncology at Massachusetts General Hospital, had the chance to speak with OncLive®, a sister publication to Oncology Nursing News®, at the 37th Annual Chemotherapy Foundation Symposium, hosted by PER®, on why these classifications do not have an impact in the clinic yet.
The majority of triple-negative breast cancers are basal, but you can also have tumors that are luminal A or luminal B. They're have also been attempts to subclassify even this basal subgroup into BL1 or BL2, but the important question to consider is, is it actionable? If I were to classify triple-negative breast cancer based on say FAM50, luminal A plus basal, does it have an impact on my clinical decision making?
And at this time, we don't have that evidence, and that's why this classification is not used in the clinic. The ER-positive, HER2-positive and triple-negative breast cancer classification is used in the clinic because it's actionable. If a tumor is ER-positive you can use endocrine therapy, if it's HER2-positive you can use anti-HER2 therapy, and for the rest, it's either chemotherapy or a clinical trial.