Facing Triple-Negative Breast Cancer: Charting Your Path With New Treatment Options & Immunotherapy

Being diagnosed with breast cancer is overwhelming, but when your doctor tells you that you have triple-negative breast cancer (TNBC), it can feel like entering uncharted territory. TNBC means that the breast cancer is estrogen receptor–negative, progesterone receptor–negative, and HER2-negative—thus, triple negative. TNBC is often seen as the “wild card” in the spectrum of breast cancer; not fitting the mold of more common types like hormone receptor–positive or HER2-positive breast cancers. It’s a diagnosis that may carry additional weight, given the aggressive nature of TNBC and the historically limited treatment options.

However, what was once a bleak outlook for those diagnosed with TNBC is now shifting. Advances in research and treatment, particularly in the realm of immunotherapy, are opening new doors, offering patients more tailored and effective ways to fight this challenging form of cancer. While TNBC is still a formidable adversary, we’re witnessing a new era in cancer care, one that empowers patients with knowledge and innovative treatment options.

Understanding TNBC: What Makes It Different

TNBC is defined by what it lacks, specifically, the absence of estrogen receptors, progesterone receptors, and HER2 proteins, which are the targets for many common breast cancer therapies. This lack of targets makes TNBC more difficult to treat using traditional hormone therapies or HER2-targeted drugs, leading to a reliance on chemotherapy as the mainstay of treatment. But this approach has its limitations, particularly in terms of long-term effectiveness.

Considering its challenges, TNBC is not a one-size-fits-all diagnosis. The disease itself is diverse, encompassing several subtypes, each with its own behavior and response to treatment. This variability has prompted researchers to explore new avenues for treatment, moving beyond the one-treatment-fits-all approach to something more personalized and precise.

Immunotherapy: A New Frontier in TNBC Treatment

One of the most promising developments in the treatment of TNBC is immunotherapy. Unlike traditional therapies that target cancer cells directly, immunotherapy empowers the body’s immune system to recognize and destroy these cells. This approach has transformed the landscape of cancer treatment, including the historically difficult-to-treat TNBC.

The approval of immunotherapy drugs, such as atezolizumab combined with chemotherapy, marks a significant advancement in TNBC care. For patients whose cancers have been resistant to conventional treatments, these new options offer renewed hope not only for prolonging life but also for improving its quality. However, the effectiveness of immunotherapy varies from patient to patient, making clinical trials crucial to understanding who benefits most.

Clinical trials play a pivotal role in advancing immunotherapy for TNBC. Every new treatment, including those now celebrated as breakthroughs, began in the clinical trial phase. These trials are essential for determining the safety and efficacy of new therapies as well as for identifying which patients are most likely to benefit. For those with TNBC, clinical trials can provide access to cutting-edge treatments that might not yet be available outside the research setting, offering a lifeline when other options have failed.

However, there is a critical issue that must be addressed: the lack of diversity in clinical trials. Historically, people of color, particularly Black and Brown women, have been underrepresented in these studies. This underrepresentation means that the results may not fully capture how different populations respond to new treatments like immunotherapy. Given that TNBC disproportionately affects Black women, increasing diversity in clinical trials is essential to ensure that these therapies are effective across all populations.

Participation in clinical trials by people of color is not only crucial for personal benefit but also for contributing to a more inclusive understanding of cancer treatment. By joining these trials, patients help close the gap in cancer disparities and advance research that could lead to more effective treatments for everyone.

Charting Your Path: Making Informed Decisions About Treatment

Facing TNBC is not just about choosing a treatment; it’s about asking questions and making decisions that resonate with your personal values, goals, and lifestyle. This is your journey, and you deserve to understand every step along the way.

Ask about the specifics of your treatment options. What are the potential benefits and risks of each? How might they impact your quality of life, both short term and long term? If immunotherapy is an option, inquire about how it works, what the success rates are, and whether you might be a good candidate. Don’t hesitate to ask about clinical trials—what trials are available to you, and how might participating in one impact your treatment journey?

It’s also important to ask questions that go beyond the medical facts. What can you expect emotionally and physically during treatment? How will this impact your day-to-day life? Are there support resources available, both for you and for your loved ones?

Remember, there’s no such thing as a “bad” question. The more you understand, the more empowered you become in shaping your journey. At the Tigerlily Foundation, we encourage you to be bold in seeking answers and fearless in your pursuit of knowledge. Your voice matters, and in every decision you make, you are taking a step toward a future filled with hope and resilience.

Stories of Hope: The Tigerlily Community's Experience With Immunotherapy

At the Tigerlily Foundation, we are a lifeline for women facing breast cancer, especially those with TNBC. Our TNBC Alliance, an initiative born from the need to address the unique challenges faced by women of color with this aggressive form of breast cancer, has been a beacon of hope and empowerment. Through the Alliance, we’ve witnessed firsthand how immunotherapy is transforming lives, offering not just treatment but renewed hope.

The TNBC Alliance is a powerful collaboration that spans across major cities like Dallas/Fort Worth and Washington, DC, and includes 14 dedicated Angel Advocates, 4 major cancer centers, a leading health system, a prominent breast cancer screening center, and 15 community-based organizations. Together, we’ve held 13 events: 8 in Dallas and 5 in Washington, DC, engaging over 6641 community members, including 2357 Black women. Among them, 193 women self-identified as having breast cancer, with 54 specifically diagnosed with TNBC.

This effort isn’t just about numbers; it’s about the lives touched and the communities empowered. Our Alliance members have driven 139 social media posts focused on events that empower the TNBC community in these 2 major cities. We’ve also gained visibility through a spotlight on Dallas’s FOX News and a documentary on Washington, DC’s, local TV, focusing on breast cancer care and equitable solutions for Black women. These media appearances help spread the word about our mission and the critical work being done.

Our educational and empowerment initiatives have been particularly impactful. We’ve delivered 8 new programs tailored to patients and providers, ensuring that every piece of material distributed is grounded in the authentic insights of TNBC patients. An incredible 91% of Alliance members contributed deliberate input into these new resources, ensuring they truly reflect the needs and experiences of the community. Furthermore, 100% of our Alliance members participated in implicit bias education and TNBC 101 training, which they are committed to disseminating within their institutions and organizations.

Through this program, we’ve learned so much about disparities in access to care—especially in relation to Black, Indigenous, People of Color (BIPOC) communities, the importance of patient respect, and the need for innovative treatments and communication strategies tailored to young BIPOC women with TNBC. Every step revealed new layers of opportunity to address, prioritize, and expand our efforts. The initial pilot of the TNBC Alliance in these major geographical areas has clearly shown the benefits of stakeholders working together towards aligned goals.

But our work doesn’t stop here. The sustainability of the TNBC Alliance is core to continually improving the complex healthcare ecosystem. As we expand our stakeholders and gather more data along the continuum of care, we remain committed to engaging the patient community and optimizing our capabilities to ensure that every woman with TNBC has the support, resources, and innovative treatments she needs.