Improving our understanding of how triple negative breast cancer responds to treatment

Breast cancer treatments don’t work the same for everyone. This is especially true for triple negative breast cancer, a more aggressive and harder-to-treat type of breast cancer. 

Part of the problem is that current treatments aren’t tailored to the unique tumour features of each person with this type of breast cancer. Instead, treatments are often chosen based on factors such as age, stage of the cancer, and the person’s overall health. 

For some people, this means they may have treatments that aren’t as effective. And for others, it could mean they have unnecessary treatments. We need to develop a deeper understanding of triple negative breast cancer and find better ways to predict how it will respond to treatment in each individual.

Triple negative breast tumours are made up of many different cell types, including immune and support cells. These cells interact in complex ways that affect how the cancer responds to treatment. 

The researchers are studying tumour samples donated by people before and during their treatment. They’re using advanced techniques that look at individual cells. This includes analysing genetic changes, gene activity and how immune cells recognise breast cancer. 

By combining this information with each person’s outcomes, the team want to build new tools to predict who will benefit from specific treatments. They also want to uncover new weaknesses in breast cancer cells that could be targeted with new drugs.

Stephen and his team are focusing on 3 projects:

1. Building a detailed map of untreated triple negative breast cancer  
   The team is studying tumour samples from 100 people with triple negative breast cancer, collected before their treatment begins. They’re studying the cancer cells and other cells in the surroundings in high detail, and analysing the genetic changes, gene activity and behaviour of these cells. 
   
   The researchers want to use this data to create a new way to classify triple negative breast cancers. In the future, this could help doctors better understand the disease and tailor treatment choices to each person’s subtype of triple negative disease.
   
   
   
2. Identifying features linked to resistance or response to treatment
   The researchers want to understand why some triple negative breast cancers respond well to treatment while others don’t. In doing so, they hope to find biological patterns linked to treatment resistance. They’re focusing on breast cancer cells and immune cells, looking at how they behave before treatment. 
   
   The researchers are also studying how breast cancer cells hide from the immune system, and whether certain genetic features make the cancer more aggressive. 
   
   Using artificial intelligence (AI), they’ll combine this information to spot key differences and potential weaknesses in tumours that are resistant to treatment. These findings could help to develop better tests or targeted therapies in future.
   
   
   
3. Tracking how breast cancer changes during treatment
   Finally, the researchers will analyse new tumour samples collected partway through treatment from the same group of 100 people. They’ll study how the breast cancer and immune cells have changed and evolved in response to therapy. 
   
   This includes identifying which cancer cell types survive treatment, and how immune cells adapt. They’ll look for warning signs that treatment isn’t working, and test whether these changes can be used to predict outcomes. 
   
   Again, using AI, they’ll develop tools to track how breast cancer evolves over time. The aim is to help doctors spot earlier when treatment stops working, so they can change course and improve outcomes for people with triple negative breast cancer.
   
   

This research could transform how triple negative breast cancer is diagnosed and treated. By identifying the features that drive treatment resistance, the team could help develop new tests to predict how someone’s breast cancer will respond before they begin therapy. This means fewer people would go through ineffective treatment, and more could be given therapies that are likely to work. 

The research could also uncover new drug targets in resistant cancers, paving the way for future treatments. And by tracking how triple negative breast cancer changes during treatment, it may help doctors spot early signs of treatments becoming ineffective and act sooner to improve outcomes.

Over 8,000 people are diagnosed with triple negative breast cancer in the UK every year. That’s 15% of all breast cancer diagnoses.