Triple Negative Breast Cancer

What is Triple Negative Breast Cancer?

Triple Negative Breast Cancer (TNBC) is defined as a heterogeneous breast cancer phenotype where the estrogen and progesterone receptor are negative, and there is a lack of overexpression of HER2, as assessed by immunohistochemistry (IHC), or the absence of its gene amplification, as assessed by fluorescence in situ hybridization technique.

There has been plethora of cases that showed China accounted for 43% of the total diagnosed incident cases, followed by the US for 24% of these cases, out of all TNBC cases in G8 countries in 2016. Amongst the EU-5 countries, Germany had the highest diagnosed incidence (32%) of TNBC in the year 2016 while Spain was accountable for the least number of TNBC incident cases.

Considering market outlook, the therapeutic market for TNBC in G8 Countries is expected to increase at a CAGR of 18.9% by 2027, for the study period 2016-2027. Currently, the therapeutic market size of metastic TNBC (mTNBC) in the United States is mainly held by the systemic chemotherapies (either alone or in combination), such as Paclitaxel (Abraxane), Erbulin (Halaven), Carboplatin, Cisplatin, and Docetaxel, among others. These chemotherapies are being used off-label, both in first line as well as in second line treatment settings of TNBC patients, with variation in the dosing frequency and drug-combinations. The United States accounts for the largest market size of TNBC, in comparison to the other G8 countries i.e., EU5 countries (the United Kingdom, Germany, Italy, France, and Spain), Japan, and China. The country held a USD 84 Million market share in 2016 and this share is expected to increase by 2027.

The TNBC treatment- Lynparza (Olaparib; AstraZeneca), a poly ADP ribose polymerase (PARP) inhibitor, became the first non-chemotherapy treatment for patients with an inherited BRCA mutation (also known as gBRCA or germline BRCA) and HER2-negative metastatic breast cancer, to receive the U.S. Food and Drugs Administration (USFDA) approval. Although the drug is not specifically approved for TNBC patients, it still provides a novel treatment option for mTNBC patients with BRCA mutation. Upcoming therapies, such as Sacituzumab Govitecan (Immunomedics) in 2019, Pembrolizumab (Roche), Niraparib (Tesaro) and Rucuparib (Clovis Oncology) have the potential to create a significant positive shift in the TNBC market size during the study period (2016-2027). The launch of Sacituzumab Govitecan in US and EU will have a significant impact on the overall market.