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Mesenchymal triple-negative breast cancers have switched on the programme cells use to migrate (epithelial-to-mesenchymal transition). They overlap with claudin-low and metaplastic tumours, respond to chemotherapy less well than basal-like 1 tumours, and are the subtype the parent page names as resisting every drug class.
The mesenchymal (M) and mesenchymal stem-like (MSL) subtypes were enriched for epithelial-to-mesenchymal transition and growth factor pathway genes, and their cell lines responded to a PI3K/mTOR inhibitor and to dasatinib in the defining study (Lehmann 2011). In the 2016 refinement the stem-like signal proved to come from tumour-associated stromal cells, leaving M as the tumour-intrinsic mesenchymal subtype (Lehmann 2016). Burstein's mesenchymal (MES) subtype carries growth factor receptor targets (PDGFR alpha, c-KIT) (Burstein 2015). The claudin-low intrinsic subtype describes much of the same biology from the whole-breast-cancer side: low luminal differentiation markers, high epithelial-to-mesenchymal transition and stem-cell features, mostly triple-negative invasive carcinomas with frequent metaplastic and medullary differentiation, and a preoperative chemotherapy response between basal-like and luminal tumours (Prat 2010); a 2020 re-analysis found claudin-low is better understood as a phenotype with low genomic instability, low proliferation and high immune and stromal infiltration that can overlay any intrinsic subtype (Fougner 2020). Metaplastic carcinoma, the histological type most often mesenchymal, is on its own page.
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; overlaps the claudin-low phenotype and the metaplastic histological type.
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 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; no mesenchymal-specific treatment is approved. PI3K/mTOR inhibitors and dasatinib were active in cell lines only.
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Query for this cancer: (TITLE:"Mesenchymal triple-negative breast cancer" OR ABSTRACT:"Mesenchymal triple-negative breast cancer" OR TITLE:"M subtype" OR ABSTRACT:"M subtype" OR TITLE:"Mesenchymal TNBC" OR ABSTRACT:"Mesenchymal TNBC" OR TITLE:"MES subtype Burstein" OR ABSTRACT:"MES subtype Burstein" OR TITLE:"Claudin-low triple-negative breast cancer overlapping phenotype" OR ABSTRACT:"Claudin-low triple-negative breast cancer overlapping phenotype") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Mesenchymal triple-negative breast cancer (M), 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.
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.
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:Pembrolizumab·Printable cards in the navigator
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