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Luminal androgen receptor cancers are triple-negative breast cancers that behave like hormone-driven tumours run by the male hormone receptor instead of oestrogen. They are less proliferative, respond less well to chemotherapy, and have shown modest benefit from prostate cancer drugs that block the androgen receptor in phase 2 trials; none is approved for breast cancer.
The luminal androgen receptor (LAR) subtype was characterised by androgen receptor signalling and luminal gene expression despite ER negativity, included patients with decreased relapse-free survival, and its cell lines were uniquely sensitive to bicalutamide (Lehmann 2011); it survived the 2016 refinement as one of four tumour-intrinsic subtypes, with a pathological complete response rate of 29 percent across five neoadjuvant datasets against 41 percent for BL1 (Lehmann 2016) and 10 percent in the MD Anderson series (Masuda 2013). Burstein's LAR subtype carries the androgen receptor and the mucin MUC1 as candidate targets and separates from the other three subtypes on DNA copy number (Burstein 2015). The molecular apocrine tumours described in France are the same entity approached from ER-negative disease: ESR1-negative, AR- and FOXA1-positive by transcript, with 67 percent HER2 3+ and 57 percent GCDFP15-positive by immunohistochemistry and a clinically aggressive course (Lehmann-Che 2013); the histological apocrine carcinoma, ER and PR negative and androgen receptor positive, is on its own page. Androgen blockade has been tested in two phase 2 trials: bicalutamide 150 mg daily gave a six-month clinical benefit rate of 19 percent and median progression-free survival of 12 weeks in 26 AR-positive, ER- and PR-negative patients (Gucalp 2013); enzalutamide 160 mg daily gave a 16-week clinical benefit rate of 25 percent in all 118 enrolled and 33 percent in the 78 with 10 percent or more nuclear AR, median progression-free survival 2.9 and 3.3 months and median overall survival 12.7 and 17.6 months, with fatigue the only grade 3 or higher treatment-related event above 2 percent (Traina 2018). Neither drug is approved for breast cancer; PIK3CA mutations are enriched in this subtype, the basis for trials combining androgen blockade with PI3K-pathway inhibitors.
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; androgen receptor was expressed by immunohistochemistry (over 10 percent of nuclei) in 12 percent of 424 ER- and PR-negative breast cancers screened for a trial (Gucalp 2013).
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 1 triple-negative breast cancer (BL1), Basal-like 2 triple-negative breast cancer (BL2), Mesenchymal triple-negative breast cancer (M), Mesenchymal stem-like triple-negative breast cancer (MSL), 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; the subtype's lower pathological complete response rate is a research observation.
Bicalutamide or enzalutamide showed clinical benefit rates of 19 to 33 percent in phase 2; not approved for breast cancer, so within a trial or after the approved options.
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Query for this cancer: (TITLE:"Luminal androgen receptor triple-negative breast cancer" OR ABSTRACT:"Luminal androgen receptor triple-negative breast cancer" OR TITLE:"LAR" OR ABSTRACT:"LAR" OR TITLE:"LAR subtype" OR ABSTRACT:"LAR subtype" OR TITLE:"Luminal androgen receptor TNBC" OR ABSTRACT:"Luminal androgen receptor TNBC" OR TITLE:"Molecular apocrine breast cancer overlapping" OR ABSTRACT:"Molecular apocrine breast cancer overlapping" OR TITLE:"AR-positive triple-negative breast cancer" OR ABSTRACT:"AR-positive triple-negative breast cancer") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Luminal androgen receptor triple-negative breast cancer (LAR), 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.
A swollen painful calf, or sudden breathlessness with chest pain; the tamoxifen boxed warning covers pulmonary embolism and stroke.
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
Seizure risk: caution with drugs that lower the seizure threshold.
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
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.
See all on the product pages:BicalutamideEnzalutamidePembrolizumab·Printable cards in the navigator
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