NCCN Guidelines for Metastatic Triple Negative Breast Cancer

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0:08 | My name is Krisite Kahl, vice president of Content for Cure Magazine. In this edition of the Speaking Out video series, we’re speaking with Dr. Rebecca Moroose of Orlando Health Cancer Institute and Dr. Virginia G. Kaklamani of UT Health San Antonio about NCCN Guideline in triple-negative breast cancer. Hi and welcome. Thank you both for joining us today. Dr. Moroose, I want to start with you. Can you briefly explain what NCCN guidelines are and maybe how they would affect a patient when it comes to their treatment decisions?

0:47 | Yes. So, the National Comprehensive Cancer Network is actually a consortium of about 30 or more academic and cancer institutes that are constantly looking at new science constantly looking at updating guidelines for doctors that they can share with their patients. For the best type of treatment depending on the patient's diagnosis.

1:11 | Okay. Dr. Kaklamani, what in particular should patients know when it comes to the NCCN guidelines?

1:19 | NCCN guidelines as Dr. Moroose mentioned, these guidelines that have been brought together by physicians colleagues of ours, they tend to be very inclusive I know a lot of Payers use those guidelines to decide whether to reimburse for treatments. And so, they're, they're not necessarily meant to tell physicians, this is exactly what you need to do their mental health physicians. These are the options that we have. So,, you can take and decide what's best for your patient.

1:48 | Okay, great. Dr. Moroose, can you just discuss the current or most recent NCCN guidelines for metastatic triple-negative breast cancer, and in particular, the physician guidelines that we had mentioned.

1:59 | Yes. This is a very exciting time for metastatic triple negative breast cancer. So in addition to systemic chemotherapy, which was always the foundation of treating metastatic triple-negative breast cancer. Now we know we can look for certain subtypes, for example, if a person has inherited their cancer because they have a germline BRCA1 and BRCA2 mutation, they've added specific targeting for that situation. If patients have expression of a mark of a receptor that makes a cancer hide from the immune system. Now we've got checkpoint inhibitors and immunotherapy. We can add, and then for the first time, an antibody drug combination called an antibody-drug conjugate that actually targets a specific protein that's overexpressed on triple-negative breast cancer. And that is really what are the exciting breakthroughs for this part of metastatic breast cancer.

3:04 | Great. Dr. Kaklamani, you know, it sounds like we're making a lot of strides in this space, which is great. So, in particular, what does this mean for this patient population then?

3:15 | Well, we've been able to show that we can improve patient survival by giving them these more targeted approaches to their therapy. So, chemotherapy and we've been using it for over 30 years to treat triple negative breast cancer. There are some good chemo therapeutic drugs but not all breast cancers are the same and to be able to find subtypes of breast cancers where we can get the help from the immune system by using immunotherapy is extremely important and thankfully, those are shown so far to improve survival those patients that express these specific markers.

3:50 | Absolutely. I think he made a great point there, not all breast cancers are treated the same. So, from the physician perspective, how do these guidelines play a role in the conversation that you're having with your patients and that the patient should be having with their healthcare provider about their treatment options?

4:09 | Well, I always tell patients that they have to be their own best advocate. They need to be informed. Obviously, they need to seek our help and guidance, but they need to know what's going on with their cancer with their body because at the end of the day, they're going to be the ones that decide what treatment they will be receiving, regardless of what we recommend. Our job is to know the latest and the greatest and to be able to apply that to the specific patient we have in front of us, but their job is to also have some understanding, and that's why these guidelines are so important that they don't just talk to physicians, they also talk to patients to the patients can understand what we what we are doing and why we're doing it and make the right decision for themselves.

4:55 I agree with that, and I think patients need to understand their therapy options, the side effects of options, and they should always ask if there is possibly a clinical research trial, for which they can enroll and participate.