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Basal-like 1 is the subtype of triple-negative breast cancer whose cancer cells are busiest dividing and worst at repairing DNA. In the studies that defined it, these tumours were the most likely to disappear completely with chemotherapy before surgery, about four in ten, and their cell lines responded best to platinum drugs.
Lehmann and colleagues analysed gene expression from 587 triple-negative cancers across 21 datasets and found six clusters; basal-like 1 (BL1) and basal-like 2 (BL2) had higher expression of cell-cycle and DNA damage response genes, and cell lines representing them preferentially responded to cisplatin (Lehmann 2011). The 2016 refinement to four tumour-specific subtypes (BL1, BL2, M and LAR) kept BL1 and showed the subtypes differ in age at diagnosis, grade, progression and histopathology; across five neoadjuvant chemotherapy datasets, 41 percent of BL1 patients reached a pathological complete response against 18 percent for BL2 and 29 percent for LAR (Lehmann 2016). In the MD Anderson series of 130 patients the BL1 subtype had the highest pathological complete response rate, 52 percent (Masuda 2013). Burstein's independent four-way classification splits the basal-like tumours by immune state instead, into basal-like immune-activated (best prognosis) and basal-like immunosuppressed (worst) (Burstein 2015). The DNA repair signature is why BL1 tumours are the natural home of the homologous recombination deficiency biology described in the glossary: HR-deficient triple-negative tumours had pathological complete response rates of 63.5 percent with carboplatin against 33.9 percent without in GeparSixto (Loibl 2018).
A research classification by gene expression (Lehmann 2011, refined 2016), not a test the NHS runs; treatment follows the triple-negative rows on the parent page.
One of the four tumour-intrinsic triple-negative subtypes in the refined Lehmann classification; the share varies by cohort and the classification is used in research, not in NHS pathology reports.
Most cancers start in the ducts and drain first to the axillary nodes, which is why the armpit is checked and a sentinel node is sampled.
Same organ: Triple-negative breast cancer (TNBC), Breast cancer (all types), HR-positive / HER2-negative breast cancer, HER2-positive breast cancer, Male breast cancer, Ductal carcinoma in situ (DCIS), High-risk early HR-positive breast cancer, HR-positive metastatic breast cancer after CDK4/6 inhibitors, HER2-low and HER2-ultralow metastatic breast cancer, Early HER2-positive breast cancer, HER2-positive breast cancer with brain metastases, Early triple-negative breast cancer, Metastatic triple-negative breast cancer, Basal-like 2 triple-negative breast cancer (BL2), Mesenchymal triple-negative breast cancer (M), Mesenchymal stem-like triple-negative breast cancer (MSL), Luminal androgen receptor triple-negative breast cancer (LAR), Immunomodulatory triple-negative breast cancer (IM), Metaplastic breast carcinoma, Carcinoma with medullary pattern (medullary breast cancer), Adenoid cystic carcinoma of the breast, Apocrine carcinoma of the breast, Secretory carcinoma of the breast, BRCA-associated triple-negative breast cancer, Inflammatory breast cancer, Paget disease of the nipple, Phyllodes tumour of the breast, Invasive lobular carcinoma of the breast, Invasive breast carcinoma of no special type (invasive ductal carcinoma), Tubular carcinoma of the breast, Mucinous carcinoma of the breast, Papillary carcinomas of the breast (encapsulated, solid and invasive papillary), Invasive cribriform carcinoma of the breast, Invasive breast carcinoma with medullary pattern (medullary carcinoma), Invasive micropapillary carcinoma of the breast, Neuroendocrine neoplasms of the breast, Lobular carcinoma in situ (LCIS)
As for triple-negative disease: pembrolizumab with carboplatin and paclitaxel then an anthracycline before surgery (KEYNOTE-522); the subtype is not used to choose treatment.
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Query for this cancer: (TITLE:"Basal-like 1 triple-negative breast cancer" OR ABSTRACT:"Basal-like 1 triple-negative breast cancer" OR TITLE:"BL1" OR ABSTRACT:"BL1" OR TITLE:"BL1 subtype" OR ABSTRACT:"BL1 subtype" OR TITLE:"Basal-like 1 TNBC" OR ABSTRACT:"Basal-like 1 TNBC" OR TITLE:"Cell-cycle and DNA damage response subtype of TNBC" OR ABSTRACT:"Cell-cycle and DNA damage response subtype of TNBC") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Basal-like 1 triple-negative breast cancer (BL1), not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Bleeding that will not stop, black or bloody stools, or unexplained bruising when platelets are expected to be low.
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
Dose by Calvert formula using GFR (see the calculators).
Immunotherapy can attack hormone-producing glands: most often the thyroid (usually ending in an under-active thyroid needing lifelong tablets), and less often the pituitary (hypophysitis) or adrenal glands, which can be life-threatening if missed.
Reactions around the moment a drug is given: chills, fever or breathlessness from antibodies (infusion reactions), true allergy (hypersensitivity, rarely anaphylaxis), and leakage of a damaging drug into tissue around the vein (extravasation).
See all on the product pages:CarboplatinPembrolizumab·Printable cards in the navigator
Newly diagnosed? Read the first 60 days with Basal-like 1 triple-negative breast cancer, then print the one-page appointment sheet with room for the answers.
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Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record.
Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked.