Triple Negative Breast Cancer at the University Hospital Mohammed VI – Oujda

Antibody-Drug Conjugates: A New Therapeutic Approach for Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is an aggressive breast cancer subset associated with a worse prognosis and poor response to conventional chemotherapy. Despite recent advances in drug discovery, its management is still a challenge for clinicians, illuminating the unmet need to develop novel treatment approaches. Antibody-drug conjugates (ADC) are innovative oncology drugs that combine the specificity of monoclonal antibodies and the high efficacy of anticancer payloads, to deliver cytotoxic drugs selectively to cancer cells. Various ADCs were investigated for TNBC and have provided a promise for this aggressive women's cancer including the FDA-approved sacituzumab govitecan. In this chapter, we reviewed different ADCs studied for TNBC including their mechanisms of action, efficacy, and tolerability. Moreover, we have also discussed their therapeutic potential based on combinatorial approaches with other targeted therapies in early and metastatic TNBC.

Clinicopathological, Treatment and Event-Free Survival Characteristics in a Moroccan Population of Triple-Negative Breast Cancer

Introduction:

Triple-negative breast cancer (TNBC) is a group of breast carcinoma characterized by the lack of expression of estrogen and progesterone hormone receptors (ER, PgR) and HER2. This form is also characterized by its aggressiveness, a low survival rate, and the absence of targeted therapies. This study was planned to evaluate the clinical features, treatment, and prognosis characteristics of TNBC in a population of Moroccan patients.

Methods:

In this retrospective study, a total of 905 patients diagnosed with breast cancer at the National Institute of Oncology in Rabat, Morocco, have been included. Based on molecular subtype, patients were divided into 2 categories: TNBC and non-TNBC patients. Data were recorded from patients’ medical files and analyzed using SPSS 13.0 software (IBM).

Results:

Overall, 17% of the patients had TNBC. At diagnosis, the median age of TNBC cases was 47 years, with extreme ages of 40 and 55 years. The median follow-up time was 30 months (10-53 months) and the 3-year survival rate was 76%. No significant difference was observed among the patients in terms of age at diagnosis, age at menarche, age at the time of first birth, nulliparity, oral contraception, and family history of breast cancer. Menopausal status and the number of pregnancy were significantly higher in the non-TNBC group. The percentage of grade 3 (G3) tumors was higher in the TNBC group (P < .001). Using neoadjuvant, adjuvant chemotherapy and radiotherapy, a net benefit in the event-free survival was registered for the 2 groups.

Conclusions:

This retrospective study was very informative and showed that women with TNBC had a less favorable prognosis than non-TNBC cases. Clinical data demonstrated that risk factors including age, premenopausal status, parity, hormonal contraceptive use, advanced disease, and a high histologic grade were independently associated with TNBC. However, large tumors and high Scarff-Bloom and Richardson grade prevail in TNBC cases with a higher incidence of lymph node metastases.

Novel Bacterial Cellulose/Gelatin Hydrogels as 3D Scaffolds for Tumor Cell Culture

Three-dimensional (3D) cells in vitro culture are becoming increasingly popular in cancer research because some important signals are lost when cells are cultured in a two-dimensional (2D) substrate. In this work, bacterial cellulose (BC)/gelatin hydrogels were successfully synthesized and were investigated as scaffolds for cancer cells in vitro culture to simulate tumor microenvironment. Their properties and ability to support normal growth of cancer cells were evaluated. In particular, the human breast cancer cell line (MDA-MD-231) was seeded into BC/gelatin scaffolds to investigate their potential in 3D cell in vitro culture. MTT proliferation assay, scanning electron microscopy, hematoxylin and eosin staining and immunofluorescence were used to determine cell proliferation, morphology, adhesion, infiltration, and receptor expression. The in vitro MDA-MD-231 cell culture results demonstrated that cells cultured on the BC/gelatin scaffolds had significant adhesion, proliferation, ingrowth and differentiation. More importantly, MDA-MD-231 cells cultured in BC/gelatin scaffolds retained triple-negative receptor expression, demonstrating that BC/gelatin scaffolds could be used as ideal in vitro culture scaffolds for tumor cells.