Medicine and Health Science Fair Project
Non-Invasive Search For Optimal Triple Negative Breast Cancer Treatment

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Project Information
Title: The Non-Invasive Search For Optimal Triple Negative Breast Cancer Treatment
Subject: Medicine and Health / Mathematics
Subcategory: Breast Cancer
Grade level: High School - Grades 10-12
Academic Level: Advanced
Project Type: Experimental
Cost: Medium
Awards: Google Science Fair Finalist
Affiliation: Google Science Fair
Year: 2014
Techniques: Lasso algorithm
Concepts: Non-invasive cancer treatment
Description: Triple Negative Breast Cancer (TNBC) is an aggressive form of breast cancer with limited treatment options, chemotherapy being one of the most effective. Currently, a special type of MRI scan called dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has high sensitivity in capturing an image of the tumor. However, it causes radiologists to diagnose more residual tumors than actually in existence, thus risking further health detriment and wasting hospital resources by sending patients into unnecessary surgery and chemotherapy. This work seeks to create a non-invasive mathematical model that will not require biopsy to determine if a patient will respond to chemotherapy by using image features that analyze and provide information on kinetic maps derived from the non-invasive DCE-MRI.

Triple-negative breast cancer treatment

Triple-negative breast cancer (sometimes abbreviated TNBC) refers to any breast cancer that does not express the genes for estrogen receptor (ER), progesterone receptor (PR) or Her2/neu. This makes it more difficult to treat since most chemotherapies target one of the three receptors, so triple-negative cancers often require combinatorial therapies (see below). Triple negative is sometimes used as a surrogate term for basal-like; however, more detailed classification may provide better guidance for treatment and better estimates for prognosis.

Standard treatment is surgery with adjuvant chemotherapy and radiotherapy. As a variation neoadjuvant chemotherapy is very frequently used for triple-negative breast cancers. This allows for a higher rate of breast-conserving surgeries and by evaluating the response to the chemotherapy gives important clues about the individual responsiveness of the particular cancer to chemotherapy.

TNBCs are generally very susceptible to chemotherapy. In some cases, however, early complete response does not correlate with overall survival. This makes it particularly complicated to find the optimal chemotherapy. Adding a taxane to the chemotherapy appears to improve outcome substantially.

BRCA1-related triple-negative breast cancer appear to be particularly susceptible to chemotherapy including platinum-based agents and taxanes.

Various molecular pathway targets and DNA results are being incorporated in the design of clinical trials of new medicines. Specific genes such as p53, NME1, BRCA and PIK3CA/Akt may be associated with responsiveness of the cancer cells to innovative research pharmaceuticals. BRCA1 and BRCA2 polymorphic variants can increase the risk of breast cancer, and these cancers tend to express a pr ofile of genes, such as p53, in a pattern that has been called "BRCA-ness." Cancers arising from BRCA1 and BRCA2 mutations, as well as other cancers that share a similar "BRCA-ness" profile, including some basal-like receptor triple negative breast cancers, may respond to treatment with PARP inhibitors such as olaparib. Combining these newer medicines with older agents such as 6-Thioguanine (6TG) may overcome the resistance that can arise in BRCA cancers to PARP inhibitors or platinum-based chemotherapy. mTOR inhibitors such as everolimus may show more effect in PIK3CA/Akt e9 mutants than in e20 mutants or wild types.

See also: Triple-Negative Breast Cancer

Source: Wikipedia (All text is available under the terms of the Creative Commons Attribution-ShareAlike License)

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