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Living with cancer· Appointment prep

Appointment sheet: Metastatic triple-negative breast cancer

One page to bring and write on: your details, the questions for Metastatic triple-negative breast cancer plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Metastatic triple-negative breast cancer

Prepared with OnCo (onco.cc/prep/tnbc-metastatic/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

22 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example PD-L1 by 22C3 combined positive score, Germline BRCA1 and BRCA2, HER2 immunohistochemistry to identify HER2-low disease, Repeat receptor testing on a metastatic biopsy, TROP2 expression), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
First line, combined positive score 10 or more
  1. 5.For my situation (first line, combined positive score 10 or more), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Pembrolizumab, Sacituzumab govitecan, and what side effects should I expect?
  3. 7.How do the results of KEYNOTE-355 and ASCENT-04 / KEYNOTE-D19 apply to someone like me?
First line, PD-L1-negative or immunotherapy-ineligible
  1. 8.For my situation (first line, pd-l1-negative or immunotherapy-ineligible), which of the standard options do you recommend and why?
  2. 9.Am I a candidate for Datopotamab deruxtecan, Sacituzumab govitecan, Paclitaxel / nab-paclitaxel or related drugs, and what side effects should I expect?
  3. 10.How do the results of TROPION-Breast02 and ASCENT-03 apply to someone like me?
Germline BRCA carriers
  1. 11.For my situation (germline brca carriers), which of the standard options do you recommend and why?
  2. 12.Am I a candidate for Olaparib, Talazoparib, Carboplatin, and what side effects should I expect?
  3. 13.How do the results of OlympiAD and EMBRACA apply to someone like me?
Second line and beyond
  1. 14.For my situation (second line and beyond), which of the standard options do you recommend and why?
  2. 15.Am I a candidate for Sacituzumab govitecan, Trastuzumab deruxtecan, Izalontamab brengitecan or related drugs, and what side effects should I expect?
  3. 16.How do the results of ASCENT and DESTINY-Breast04 apply to someone like me?
Brain metastases
  1. 17.For my situation (brain metastases), which of the standard options do you recommend and why?
Any stage
  1. 18.Are there clinical trials I could join, for example of Izalontamab brengitecan, BL-B01D1-307, Sacituzumab tirumotecan, TROPION-Breast05?
  2. 19.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 20.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 21.I read that “Cross-resistance between antibody-drug conjugates sharing a topoisomerase I payload”. How does that affect my plan?
  5. 22.I read that “No biomarker selects patients for TROP2 drugs”. How does that affect my plan?

The words I may hear

  • Germline BRCA mutation (gBRCA): An inherited fault in the BRCA1 or BRCA2 gene, present in every cell from birth, that greatly raises the risk of breast, ovarian, prostate and pancreatic cancer and makes those cancers sensitive to PARP inhibitors and platinum.
  • Combined positive score (CPS): A PD-L1 score that counts stained tumour cells and immune cells together.
  • Brain metastases (intracranial disease): Tumour deposits that have travelled to the brain from a cancer elsewhere, ten times more common than cancers that start in the brain, mostly from lung, breast, melanoma and kidney cancer.

Tests and results to bring

Biomarker results to ask for: PD-L1 by 22C3 combined positive score (10 or more for pembrolizumab), Germline BRCA1 and BRCA2 (PARP inhibitors), HER2 immunohistochemistry to identify HER2-low disease, Repeat receptor testing on a metastatic biopsy (receptor conversion), TROP2 expression (not required for TROP2 antibody-drug conjugates), Tumour mutational burden and microsatellite instability (tumour-agnostic immunotherapy).

Scans and tests linked to this cancer: MRD / molecular residual disease testing, TROP2 PET.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call