Triple-negative breast carcinoma

disease
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Also known as triple-negative breast cancertriple-receptor negative breast cancer

Summary

Triple-negative breast carcinoma (MONDO:0005494) is a cancer with 11 cohort genes (45 GWAS associations across 13 studies; 10 CIViC-evidence somatic drivers; 1 ClinVar predisposition record) and 742 clinical trials. The dominant Reactome pathway is Defective homologous recombination repair (HRR) due to PALB2 loss of function (3 cohort genes). Molecularly, BRCA1 Loss-of-function confers sensitivity to Olaparib in Triple-receptor Negative Breast Cancer (CIViC Level A); 18 further subtype–drug associations are mapped below. Top therapeutic interventions include carboplatin, eribulin, and sacituzumab govitecan.

At a glance

  • Classification: Cancer
  • Cohort genes: 11
  • GWAS associations: 45
  • ClinVar variants: 1
  • Clinical trials: 742
  • Precision-medicine evidence (CIViC): 19 subtype–drug associations

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical nametriple-negative breast carcinoma
Mondo IDMONDO:0005494
EFOEFO:0005537
MeSHD064726
DOIDDOID:0060081
NCITC71732
SNOMED CT706970001
UMLSC4722518
MedGen1649548
Is cancer (heuristic)yes

Also known as: triple-negative breast cancer · triple-negative breast carcinoma · triple-receptor negative breast cancer

Data availability: 1 ClinVar variant · 45 GWAS associations (13 studies) · 1 cell line.

Disease family

An umbrella term covering 1 Mondo subtype.

Classification path: human disease › disease by etiologic mechanism › cancer or benign tumorneoplastic disease or syndromeneoplasmcancercarcinomabreast carcinomabreast carcinoma by gene expression profileprogesterone-receptor negative breast cancertriple-negative breast carcinoma

Subtypes (1): basal-like breast carcinoma

Genetics & variants

GWAS landscape

45 GWAS associations across 13 studies. Top hits map to 22 distinct genes (as reported by GWAS).

Top associations by p-value

rsIDp-valueGeneRisk alleleOdds ratio
rs100696901e-23TERTT1.38
rs129745081e-23ANKLE1 - ABHD8C1.38
rs108282472e-13MLLT10A0.03
rs172152319e-13RPS18C1.18
rs75802406e-11TRMT61B - WDR43C0.03
rs766640324e-10LINC01956A1.3
rs778255131e-09NR2F6A0.02
rs43877131e-09GTPBP3 - PLVAPT0.02
rs108908412e-09C11orf65T0.02
rs132584342e-09NACA4P - LINC02845G0.03
rs37451914e-09ANO8C0.02
rs22704185e-09TNFSF10T0.02
rs69822266e-09LINC00536G0.02
rs120943888e-09LRRN2A0.02
rs783782221e-08TP53T1.45
rs48669001e-08FGF10-AS1 - MRPS30-DTG0.02
rs23639562e-08ANKLE1C1.22
rs107713992e-08PTHLH - CCDC91G1.39
rs65478942e-08WDR43G0.02
rs31300142e-08MYL12BP3 - LYPLA2P1A0.02
rs12431842e-08MLLT10T0.03
rs1119997092e-08IL20RB - RNA5SP142C1.2
rs1892300422e-08RNA5SP224 - RNA5SP225A1.36
rs24641953e-08HNF1AG1.08
rs5348298943e-08IL20RB - RNA5SP142A1.2
rs1133784193e-08IL20RB - RNA5SP142T1.2
rs115983803e-08HACD1 - STAM-DTT1.45
rs748291224e-08SLC6A18G0.02
rs1112956394e-08IL20RB - RNA5SP142C1.19
rs1122629984e-08IL20RB - RNA5SP142A1.19

Top studies (by case count)

StudyLead authorYearCasesControlsTitle
GCST010100Zhang H202018,016100,971Genome-wide association study identifies 32 novel breast cancer susceptibility loci from overall and subtype-specific analyses.
GCST90446470Sun X202416,4990Case-Case Genome-Wide Analyses Identify Subtype-Informative Variants that Confer Risk for Breast Cancer.
GCST90446471Sun X202416,4990Case-Case Genome-Wide Analyses Identify Subtype-Informative Variants that Confer Risk for Breast Cancer.
GCST90446472Sun X202416,4990Case-Case Genome-Wide Analyses Identify Subtype-Informative Variants that Confer Risk for Breast Cancer.
GCST90446474Sun X202416,4990Case-Case Genome-Wide Analyses Identify Subtype-Informative Variants that Confer Risk for Breast Cancer.
GCST90454344Zhang H202014,90091,477Genome-wide association study identifies 32 novel breast cancer susceptibility loci from overall and subtype-specific analyses.
GCST90652497Jia G20257,17894,407Refining breast cancer genetic risk and biology through multi-ancestry fine-mapping analyses of 192 risk regions.
GCST90296722Jia G20242,86016,262Genome-wide association analyses of breast cancer in women of African ancestry identify new susceptibility loci and improve risk prediction.
GCST002305Purrington KS20131,5293,399Genome-wide association study identifies 25 known breast cancer susceptibility loci as risk factors for triple-negative breast cancer.
GCST90551896Hayat M20252621,101Genome-wide association study identifies common variants associated with breast cancer in South African Black women.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

TierVariants
Tier 1: coding2
Tier 2: splice/UTR3
Tier 3: regulatory2
Tier 4: intronic/intergenic37

MAF distribution

BucketVariants
common (>=0.05)37
low_freq (0.01-0.05)1
rare (<0.01)0
unknown6

Functional consequences

ConsequenceCount
intron_variant22
intergenic_variant14
3_prime_UTR_variant2
missense_variant2
TF_binding_site_variant1
5_prime_UTR_variant1
regulatory_region_variant1
synonymous_variant1

Top variants

rsIDChrPosAllelesMAFConsequenceGenep-valueTier
rs1006969051279675C>T0.41intron_variantTERT1e-23Tier 4: intronic/intergenic
rs129745081917290712C>A,T0.41intergenic_variantANKLE1 - ABHD81e-23Tier 4: intronic/intergenic
rs108282471021533927A>C,G0.05TF_binding_site_variantMLLT102e-13Tier 3: regulatory
rs17215231633272092C>A,T0.085_prime_UTR_variantRPS189e-13Tier 2: splice/UTR
rs7580240228891506C>T0.05intergenic_variantTRMT61B - WDR436e-11Tier 4: intronic/intergenic
rs766640322118823485A>C,G,T0.19intron_variantLINC019564e-10Tier 4: intronic/intergenic
rs778255131917236900C>A0.05intron_variantNR2F61e-09Tier 4: intronic/intergenic
rs43877131917349088T>A,C,G0.05regulatory_region_variantGTPBP3 - PLVAP1e-09Tier 3: regulatory
rs1089084111108447224C>T0.05intron_variantC11orf652e-09Tier 4: intronic/intergenic
rs132584348101379857G>A,T0.05intergenic_variantNACA4P - LINC028452e-09Tier 4: intronic/intergenic
rs37451911917328225C>T0.05synonymous_variantANO84e-09Tier 4: intronic/intergenic
rs22704183172523209T>C,G0.05intron_variantTNFSF105e-09Tier 4: intronic/intergenic
rs69822268116002917G>C,T0.05intron_variantLINC005366e-09Tier 4: intronic/intergenic
rs120943881204623046A>C,G,T0.05intron_variantLRRN28e-09Tier 4: intronic/intergenic
rs78378222177668434T>A,G0.013_prime_UTR_variantTP531e-08Tier 2: splice/UTR
rs4866900544444998G>A,C0.05intergenic_variantFGF10-AS1 - MRPS30-DT1e-08Tier 4: intronic/intergenic
rs23639561917283315T>G0.05missense_variantANKLE12e-08Tier 1: coding
rs107713991228002147A>G0.05intergenic_variantPTHLH - CCDC912e-08Tier 4: intronic/intergenic
rs6547894228920924A>G0.05intron_variantWDR432e-08Tier 4: intronic/intergenic
rs3130014633344531A>C,G,T0.05intergenic_variantMYL12BP3 - LYPLA2P12e-08Tier 4: intronic/intergenic
rs12431841021643008T>C0.05intron_variantMLLT102e-08Tier 4: intronic/intergenic
rs1119997093137423188T>Cintergenic_variantIL20RB - RNA5SP1422e-08Tier 4: intronic/intergenic
rs1892300426153380909T>Aintron_variantRNA5SP224 - RNA5SP2252e-08Tier 4: intronic/intergenic
rs246419512120997672G>A,C0.37missense_variantHNF1A3e-08Tier 1: coding
rs5348298943137407328G>A,Tintergenic_variantIL20RB - RNA5SP1423e-08Tier 4: intronic/intergenic
rs1133784193137423356C>Tintergenic_variantIL20RB - RNA5SP1423e-08Tier 4: intronic/intergenic
rs115983801017627071C>A,T0.05intergenic_variantHACD1 - STAM-DT3e-08Tier 4: intronic/intergenic
rs7482912251241450A>G0.05intron_variantSLC6A184e-08Tier 4: intronic/intergenic
rs1112956393137405804G>Cintergenic_variantIL20RB - RNA5SP1424e-08Tier 4: intronic/intergenic
rs1122629983137407888G>Aintergenic_variantIL20RB - RNA5SP1424e-08Tier 4: intronic/intergenic

ClinVar germline variants

1 retrieved; paginated sample, class counts are floors:

1 benign/likely benign

ClinVarVariant (HGVS)GeneClassificationReview
132706NM_000051.4(ATM):c.5497-8T>CATMBenign/Likely benigncriteria provided, multiple submitters, no conflicts

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 63 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Somatic driver evidence (intOGen + CIViC, cohort fanout)

GeneintOGen roleCancer typesCIViC
BRCA1LoFBLCA,BRCA,MEL,OVTCIViC #6
BRCA2LoFBLCA,BRCA,CESC,CHOL,HCC,HNSC,LUSC,MBL,OVT,PAAD,PRAD,PROSTATE,RCC,VULVACIViC #7
ERBB2ActBLCA,BRCA,CESC,CHOL,COADREAD,EGC,ESCA,ESCC,LMS,LUAD,NSCLC,OVT,PRCC,READ,STAD,UCECCIViC #20
FGFR2ActBRCA,CHOL,LUSC,SACA,UCECCIViC #22
AKT3ActPROSTATE,SKCMCIViC #7936
RB1LoFACC,BLADDER,BLCA,BRCA,CESC,ESCA,GB,GBM,GIST,HCC,HNSC,LGGNOS,LIPO,LMS,LUAD,LUSC,MEL,MT,NSCLC,OS,OVT,PANCREAS,PCM,PRAD,PROSTATE,RBL,SCLC,SKCM,SOFT_TISSUE,STAD,STOMACH,UCEC,UCSCIViC #4795
TERTActPRCCCIViC #79
ESR1ActBRCA,LUSC,MEL,UCECCIViC #21
MDM4CIViC #3466
ATMLoFBLCA,BRCA,CCRCC,CHOL,CLLSLL,COAD,COADREAD,ESCA,HCC,LUAD,LUSC,MEL,NSCLC,PAAD,PANCREAS,PANET,PCM,PLMESO,PRAD,PROSTATE,STAD,UCEC,UTUC,WDTCCIViC #69

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
BRCA1Orphanet:1331Familial prostate cancer
BRCA1Orphanet:1333Familial pancreatic carcinoma
BRCA1Orphanet:145Hereditary breast and/or ovarian cancer syndrome
BRCA1Orphanet:168829Primary peritoneal carcinoma
BRCA1Orphanet:227535Hereditary breast cancer
BRCA1Orphanet:667662Breast implant-associated anaplastic large cell lymphoma
BRCA1Orphanet:694963Inflammatory breast cancer
BRCA1Orphanet:70567Cholangiocarcinoma
BRCA1Orphanet:84Fanconi anemia
BRCA2Orphanet:1331Familial prostate cancer
BRCA2Orphanet:1333Familial pancreatic carcinoma
BRCA2Orphanet:145Hereditary breast and/or ovarian cancer syndrome
BRCA2Orphanet:178Chordoma
BRCA2Orphanet:227535Hereditary breast cancer
BRCA2Orphanet:319462Inherited cancer-predisposing syndrome due to biallelic BRCA2 mutations
BRCA2Orphanet:440437Familial colorectal cancer Type X
BRCA2Orphanet:654Nephroblastoma
BRCA2Orphanet:667662Breast implant-associated anaplastic large cell lymphoma
BRCA2Orphanet:694963Inflammatory breast cancer
BRCA2Orphanet:70567Cholangiocarcinoma
BRCA2Orphanet:84Fanconi anemia
ERBB2Orphanet:213726Serous carcinoma of the corpus uteri
ERBB2Orphanet:2800Extramammary Paget disease
ERBB2Orphanet:388Hirschsprung disease
ERBB2Orphanet:99976Adenocarcinoma of the oesophagus and oesophagogastric junction
FGFR2Orphanet:1540Jackson-Weiss syndrome
FGFR2Orphanet:1555Cutis gyrata-acanthosis nigricans-craniosynostosis syndrome
FGFR2Orphanet:168624Familial scaphocephaly syndrome, McGillivray type
FGFR2Orphanet:207Crouzon syndrome
FGFR2Orphanet:2363Lacrimoauriculodentodigital syndrome
FGFR2Orphanet:313855FGFR2-related bent bone dysplasia
FGFR2Orphanet:596008Antley-Bixler syndrome without genital anomaly or disorder of steroidogenesis
FGFR2Orphanet:794Saethre-Chotzen syndrome
FGFR2Orphanet:87Apert syndrome
FGFR2Orphanet:93258Pfeiffer syndrome type 1
FGFR2Orphanet:93259Pfeiffer syndrome type 2
FGFR2Orphanet:93260Pfeiffer syndrome type 3
AKT3Orphanet:83473Megalencephaly-polymicrogyria-postaxial polydactyly-hydrocephalus syndrome
AKT3Orphanet:99802Hemimegalencephaly
RB1Orphanet:1587Monosomy 13q14 syndrome
RB1Orphanet:357027Hereditary retinoblastoma
RB1Orphanet:357034Non-hereditary retinoblastoma
RB1Orphanet:668Osteosarcoma
RB1Orphanet:70573Small cell lung cancer
TERTOrphanet:146Differentiated thyroid carcinoma
TERTOrphanet:1501Adrenocortical carcinoma
TERTOrphanet:1775Dyskeratosis congenita
TERTOrphanet:2032Idiopathic pulmonary fibrosis
TERTOrphanet:2495Meningioma
TERTOrphanet:3322Hoyeraal-Hreidarsson syndrome

Cohort genes → proteins

11 cohort genes, 11 distinct canonical proteins.

Evidence partition

SubsetGenes
gwas_only4
civic_only6
multi_evidence1

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
BRCA1HGNC:1100ENSG00000012048P38398Breast cancer type 1 susceptibility proteincivic_evidence
BRCA2HGNC:1101ENSG00000139618P51587Breast cancer type 2 susceptibility proteincivic_evidence
ERBB2HGNC:3430ENSG00000141736P04626Receptor tyrosine-protein kinase erbB-2civic_evidence
FGFR2HGNC:3689ENSG00000066468P21802Fibroblast growth factor receptor 2civic_evidence
AKT3HGNC:393ENSG00000117020Q9Y243RAC-gamma serine/threonine-protein kinasecivic_evidence
RB1HGNC:9884ENSG00000139687P06400Retinoblastoma-associated proteincivic_evidence
TERTHGNC:11730ENSG00000164362O14746Telomerase reverse transcriptasegwas
ESR1HGNC:3467ENSG00000091831P03372Estrogen receptorgwas
MDM4HGNC:6974ENSG00000198625O15151Protein Mdm4gwas
ATMHGNC:795ENSG00000149311Q13315Serine-protein kinase ATMclinvar
PTHLHHGNC:9607ENSG00000087494P12272Parathyroid hormone-related proteingwas

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
BRCA1Breast cancer type 1 susceptibility proteinE3 ubiquitin-protein ligase that specifically mediates the formation of ‘Lys-6’-linked polyubiquitin chains and plays a central role in DNA repair by facilitating cellular responses to DNA damage.
BRCA2Breast cancer type 2 susceptibility proteinInvolved in double-strand break repair and/or homologous recombination.
ERBB2Receptor tyrosine-protein kinase erbB-2Protein tyrosine kinase that is part of several cell surface receptor complexes, but that apparently needs a coreceptor for ligand binding.
FGFR2Fibroblast growth factor receptor 2Tyrosine-protein kinase that acts as a cell-surface receptor for fibroblast growth factors and plays an essential role in the regulation of cell proliferation, differentiation, migration and apoptosis, and in the regulation of embryonic de…
AKT3RAC-gamma serine/threonine-protein kinaseAKT3 is one of 3 closely related serine/threonine-protein kinases (AKT1, AKT2 and AKT3) called the AKT kinase, and which regulate many processes including metabolism, proliferation, cell survival, growth and angiogenesis.
RB1Retinoblastoma-associated proteinTumor suppressor that is a key regulator of the G1/S transition of the cell cycle.
TERTTelomerase reverse transcriptaseTelomerase is a ribonucleoprotein enzyme essential for the replication of chromosome termini in most eukaryotes.
ESR1Estrogen receptorNuclear hormone receptor.
MDM4Protein Mdm4Contributes to p53/TP53 regulation.
ATMSerine-protein kinase ATMSerine/threonine protein kinase which activates checkpoint signaling upon double strand breaks (DSBs), apoptosis and genotoxic stresses such as ionizing ultraviolet A light (UVA), thereby acting as a DNA damage sensor.
PTHLHParathyroid hormone-related proteinNeuroendocrine peptide which is a critical regulator of cellular and organ growth, development, migration, differentiation and survival and of epithelial calcium ion transport.

Protein-family classification

Druggable: 5 · Difficult: 2 · Unknown: 4 · Druggable fraction: 0.45

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Kinase410.1×0.002
Nuclear receptor135.1×0.056
Transcription factor21.5×0.523
Other/Unknown40.7×0.946

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
BRCA1Transcription factorno2.3.2.27BRCT_dom, Znf_RING, BRCA1
BRCA2Other/UnknownnoBRCA2_repeat, NA-bd_OB-fold, BRCA2_OB_1
ERBB2Kinaseyes2.7.10.1Rcpt_L-dom, Prot_kinase_dom, Ser-Thr/Tyr_kinase_cat_dom
FGFR2Kinaseyes2.7.10.1Prot_kinase_dom, Ser-Thr/Tyr_kinase_cat_dom, Ig_sub2
AKT3Kinaseyes2.7.11.1Prot_kinase_dom, AGC-kinase_C, PH_domain
RB1Other/UnknownnoRB_B, RB_A, Cyclin-like_dom
TERTOther/UnknownnoRT_dom, Telomerase_RT, Telomerase_RBD
ESR1Nuclear receptoryesNucl_hrmn_rcpt_lig-bd, Estr_rcpt, Znf_hrmn_rcpt
MDM4Transcription factornoZnf_RING, Znf_RanBP2, SWIB_MDM2_domain
ATMKinaseyes2.7.11.1PI3/4_kinase_cat_dom, PIK-rel_kinase_FAT, FATC_dom
PTHLHOther/UnknownnoPTH/PTH-rel, PTH-rel

Expression context

Cohort genes with no expression data: 0.

10 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)11
unknown0

Top tissues across cohort

TissueCohort genes
male germ line stem cell (sensu Vertebrata) in testis2
primordial germ cell in gonad2
ventricular zone2
corpus callosum2
calcaneal tendon2
stromal cell of endometrium2
colonic epithelium2
secondary oocyte1
lower esophagus mucosa1
right uterine tube1
sural nerve1
C1 segment of cervical spinal cord1
spinal cord1
cortical plate1
embryo1
choroid plexus epithelium1
epithelium of nasopharynx1
visceral pleura1
olfactory bulb1
type B pancreatic cell1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
BRCA1208ubiquitousmarkerventricular zone, male germ line stem cell (sensu Vertebrata) in testis, primordial germ cell in gonad
BRCA2184ubiquitousmarkermale germ line stem cell (sensu Vertebrata) in testis, secondary oocyte, ventricular zone
ERBB2276ubiquitousmarkerlower esophagus mucosa, right uterine tube, sural nerve
FGFR2272broadmarkerC1 segment of cervical spinal cord, spinal cord, corpus callosum
AKT3231ubiquitousmarkercortical plate, calcaneal tendon, embryo
RB1287ubiquitousmarkerepithelium of nasopharynx, choroid plexus epithelium, visceral pleura
TERT105broadyesstromal cell of endometrium, type B pancreatic cell, olfactory bulb
ESR1216broadmarkeroviduct epithelium, cervix epithelium, mammalian vulva
MDM4270ubiquitousmarkernipple, oocyte, colonic epithelium
ATM286ubiquitousmarkercalcaneal tendon, colonic epithelium, corpus callosum
PTHLH202broadmarkerperiodontal ligament, primordial germ cell in gonad, stromal cell of endometrium

Protein interactions among cohort

Intra-cohort edges: 6.

Hub genes (top 10 by interactor count)

SymbolInteractor count
ESR112,382
ERBB29,659
BRCA19,064
ATM7,383
TERT5,717
BRCA24,839
RB14,374
MDM43,431
AKT33,392
PTHLH1,599

Intra-cohort edges

ABSources
ATMBRCA1string_interaction
ATMBRCA2string_interaction
ATMMDM4string_interaction
BRCA1BRCA2string_interaction
BRCA1ESR1intact, string_interaction
BRCA1MDM4string_interaction

Structural data

PDB: 11 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
ESR1P03372478
ERBB2P0462663
FGFR2P2180263
MDM4O1515139
BRCA1P3839833
TERTO1474623
RB1P0640019
BRCA2P5158714
ATMQ1331514
PTHLHP1227211
AKT3Q9Y2432

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 230. Enrichment computed across 11 evidence-associated genes (11 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 11 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Defective homologous recombination repair (HRR) due to PALB2 loss of function3259.6×1e-05BRCA1, BRCA2, ATM
Diseases of DNA Double-Strand Break Repair3222.5×1e-05BRCA1, BRCA2, ATM
Defective homologous recombination repair (HRR) due to BRCA2 loss of function3222.5×1e-05BRCA1, BRCA2, ATM
Cell Cycle619.6×1e-05BRCA1, BRCA2, TERT, AKT3, MDM4, ATM
Resolution of D-Loop Structures3173.0×2e-05BRCA1, BRCA2, ATM
Diseases of DNA repair3155.7×3e-05BRCA1, BRCA2, ATM
Regulation of TP53 Expression and Degradation3141.6×3e-05AKT3, MDM4, ATM
Regulation of TP53 Activity448.3×3e-05BRCA1, AKT3, MDM4, ATM
Impaired BRCA2 binding to PALB23124.6×4e-05BRCA1, BRCA2, ATM
Defective homologous recombination repair (HRR) due to BRCA1 loss of function3115.3×4e-05BRCA1, BRCA2, ATM
Defective HDR through Homologous Recombination Repair (HRR) due to PALB2 loss of BRCA1 binding function3115.3×4e-05BRCA1, BRCA2, ATM
Defective HDR through Homologous Recombination Repair (HRR) due to PALB2 loss of BRCA2/RAD51/RAD51C binding function3115.3×4e-05BRCA1, BRCA2, ATM
Resolution of D-loop Structures through Synthesis-Dependent Strand Annealing (SDSA)3107.4×4e-05BRCA1, BRCA2, ATM
Homologous DNA Pairing and Strand Exchange3103.8×4e-05BRCA1, BRCA2, ATM
Homology Directed Repair384.2×7e-05BRCA1, BRCA2, ATM
HDR through Homologous Recombination (HRR) or Single Strand Annealing (SSA)384.2×7e-05BRCA1, BRCA2, ATM
Impaired BRCA2 binding to RAD51384.2×7e-05BRCA1, BRCA2, ATM
Resolution of D-loop Structures through Holliday Junction Intermediates382.0×7e-05BRCA1, BRCA2, ATM
Regulation of TP53 Degradation379.9×7e-05AKT3, MDM4, ATM
Meiosis377.9×7e-05BRCA1, BRCA2, ATM
Presynaptic phase of homologous DNA pairing and strand exchange374.2×8e-05BRCA1, BRCA2, ATM
DNA Double-Strand Break Repair367.7×1e-04BRCA1, BRCA2, ATM
PIP3 activates AKT signaling424.3×1e-04ERBB2, ESR1, FGFR2, AKT3
Regulation of MITF-M-dependent genes involved in DNA replication, damage repair and senescence2296.6×2e-04BRCA1, TERT
Transcriptional Regulation by TP53422.6×2e-04BRCA1, AKT3, MDM4, ATM
Reproduction351.9×2e-04BRCA1, BRCA2, ATM
HDR through Homologous Recombination (HRR)351.9×2e-04BRCA1, BRCA2, ATM
Meiotic recombination335.4×6e-04BRCA1, BRCA2, ATM
Downregulation of ERBB2:ERBB3 signaling2148.3×6e-04ERBB2, AKT3
Constitutive Signaling by Aberrant PI3K in Cancer334.6×6e-04ERBB2, ESR1, FGFR2

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 11 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
prostate epithelial cord elongation21021.3×4e-04ESR1, FGFR2
DNA damage response, signal transduction by p53 class mediator397.8×6e-04BRCA2, MDM4, ATM
prostate epithelial cord arborization involved in prostate glandular acinus morphogenesis2437.7×8e-04ESR1, FGFR2
establishment of protein localization to telomere2383.0×8e-04BRCA2, TERT
regulation of cell cycle427.1×8e-04BRCA1, MDM4, ATM, RB1
telomere maintenance via recombination2278.6×0.001BRCA2, TERT
double-strand break repair355.4×0.001BRCA1, BRCA2, ATM
regulation of DNA damage checkpoint2204.3×0.002BRCA1, BRCA2
double-strand break repair via homologous recombination342.6×0.002BRCA1, BRCA2, ATM
replicative senescence2180.2×0.002TERT, ATM
cellular response to hypoxia333.1×0.003TERT, FGFR2, MDM4
positive regulation of angiogenesis331.5×0.003BRCA1, TERT, AKT3
negative regulation of cellular senescence2117.8×0.004TERT, AKT3
regulation of ERK1 and ERK2 cascade2105.7×0.004ERBB2, FGFR2
digestive tract development295.8×0.005FGFR2, RB1
mitotic G2 DNA damage checkpoint signaling280.6×0.006BRCA1, ATM
positive regulation of vascular associated smooth muscle cell proliferation278.6×0.006TERT, FGFR2
peptidyl-tyrosine phosphorylation276.6×0.006ERBB2, FGFR2
response to ionizing radiation274.7×0.006BRCA1, ATM
cellular response to ionizing radiation274.7×0.006BRCA1, BRCA2
heart development321.5×0.006TERT, ERBB2, ATM
positive regulation of Wnt signaling pathway269.6×0.006TERT, FGFR2
chromatin remodeling319.9×0.006BRCA1, ESR1, RB1
RNA-templated transcription11532.0×0.007TERT
DNA strand elongation11532.0×0.007TERT
fibroblast growth factor receptor signaling pathway involved in negative regulation of apoptotic process in bone marrow cell11532.0×0.007FGFR2
fibroblast growth factor receptor signaling pathway involved in hemopoiesis11532.0×0.007FGFR2
fibroblast growth factor receptor signaling pathway involved in positive regulation of cell proliferation in bone marrow11532.0×0.007FGFR2
lateral sprouting from an epithelium11532.0×0.007FGFR2
siRNA transcription11532.0×0.007TERT

Therapeutics

Drugs indicated for this disease

2 approved, 17 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

DrugDevelopment status
AtezolizumabApproved (phase 4)
Sacituzumab GovitecanApproved (phase 4)
CamrelizumabPhase 3 (in late-stage trials)
CapecitabinePhase 3 (in late-stage trials)
CarboplatinPhase 3 (in late-stage trials)
CisplatinPhase 3 (in late-stage trials)
DoxorubicinPhase 3 (in late-stage trials)
EpirubicinPhase 3 (in late-stage trials)
EribulinPhase 3 (in late-stage trials)
FamitinibPhase 3 (in late-stage trials)
FilgrastimPhase 3 (in late-stage trials)
GemcitabinePhase 3 (in late-stage trials)
IpatasertibPhase 3 (in late-stage trials)
PaclitaxelPhase 3 (in late-stage trials)
PegfilgrastimPhase 3 (in late-stage trials)
PembrolizumabPhase 3 (in late-stage trials)
ToripalimabPhase 3 (in late-stage trials)
TrilaciclibPhase 3 (in late-stage trials)
VinorelbinePhase 3 (in late-stage trials)

Earlier-phase candidates (phase 2, investigational — efficacy not yet established): Alpelisib, Anastrozole, Avelumab, Bavituximab, Bevacizumab, Binimetinib, Capivasertib, Catequentinib, Ceralasertib, Cirmtuzumab, Dasatinib Anhydrous, Datopotamab Deruxtecan, Durvalumab, Efavirenz, Enobosarm, Entinostat, Enzalutamide, Estradiol, Everolimus, Exemestane, Fluzoparib, Ibcasertib, Inosine, Ivonescimab, Ivuxolimab, Letrozole, Magrolimab, Metformin, Mirvetuximab Soravtansine, Olaparib, Panitumumab, Pelareorep, Platinum, Propranolol, Pyrotinib, Quercetin, Retifanlimab, Rivoceranib, Sargramostim, Selumetinib, Spartalizumab, Talazoparib, Tislelizumab, Tivantinib, Trametinib, Trastuzumab, Trastuzumab Deruxtecan, Tucidinostat, Utomilumab, Veliparib.

Drug target analysis

Approved (phase 4): 8 · Phase ≥3: 8 · Phased (≥1): 9 · Undrugged: 2

Druggability breadth: 10 of 11 evidence-associated genes (91%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Genes with an approved drug

The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.

SymbolExample approved molecule
BRCA1RIBOFLAVIN
ERBB2CLOTRIMAZOLE
FGFR2PONATINIB
AKT3CAPIVASERTIB
TERTBERBERINE
ESR1CANDESARTAN CILEXETIL
MDM4DIOSMIN
ATMAMIODARONE HYDROCHLORIDE

Top cohort targets by molecule count

SymbolMoleculesMax phase
ESR11624
ERBB2834
FGFR2594
ATM354
AKT3184
BRCA1124
TERT104
MDM474
RB112
BRCA200

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
RIBOFLAVIN4BRCA1
DAUNORUBICIN HYDROCHLORIDE4BRCA1
TOPOTECAN HYDROCHLORIDE4BRCA1
DAUNORUBICIN4BRCA1, ESR1
DOXORUBICIN HYDROCHLORIDE4BRCA1
MESALAMINE4BRCA1
DIPYRIDAMOLE4ATM, BRCA1
CLOTRIMAZOLE4ERBB2
ERLOTINIB HYDROCHLORIDE4ERBB2
PONATINIB4ERBB2, FGFR2
AFATINIB4ERBB2
LAPATINIB DITOSYLATE4ERBB2
SORAFENIB4ERBB2, FGFR2
NERATINIB4ERBB2
IBRUTINIB4ERBB2, FGFR2
AFATINIB DIMALEATE4ERBB2
CABOZANTINIB4ERBB2
DACOMITINIB4ERBB2
DACOMITINIB ANHYDROUS4ERBB2
VANDETANIB4ERBB2, FGFR2
TRIBROMSALAN4ERBB2
BOSUTINIB4ERBB2
BITHIONOL4ERBB2, ESR1
ASTEMIZOLE4ERBB2
EBASTINE4ERBB2
OSIMERTINIB4ERBB2
BRIGATINIB4ERBB2, FGFR2
ACALABRUTINIB4ERBB2
ZANUBRUTINIB4ERBB2
TUCATINIB4ERBB2

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 5.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
ESR12,435Binding:2037, Functional:363, ADMET:35
ERBB21,221Binding:1136, Functional:79, ADMET:6
FGFR2966Binding:940, Functional:22, ADMET:4
AKT3660Binding:644, Functional:16
TERT391Binding:389, Functional:2
ATM240Binding:233, Functional:5, ADMET:2
MDM4149Binding:148, Functional:1
RB159Binding:59
BRCA113Binding:9, Functional:4

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
BRCA12.3.2.27RING-type E3 ubiquitin transferase
ERBB22.7.10.1receptor protein-tyrosine kinase
FGFR22.7.10.1receptor protein-tyrosine kinase
AKT32.7.11.1non-specific serine/threonine protein kinase
ATM2.7.11.1non-specific serine/threonine protein kinase

Cohort genes with high screening signal

≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.

SymbolChEMBL assays
ERBB21,221
FGFR2966
AKT3660
TERT391
ESR12,435
MDM4149
ATM240

Pharmacogenomics

Cohort genes with a PharmGKB record: 11; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Drug repurposing candidates

29 approved/phased drugs hit cohort targets but don’t yet appear in disease-level clinical trials. Target-inhibition rationale is strongest for cancer driver genes; a bioactivity hit is a screening signal, not a treatment claim.

CompoundMax phaseCohort target (bioactivity)
RIBOFLAVIN4BRCA1
DAUNORUBICIN HYDROCHLORIDE4BRCA1
TOPOTECAN HYDROCHLORIDE4BRCA1
DAUNORUBICIN4BRCA1, ESR1
DOXORUBICIN HYDROCHLORIDE4BRCA1
MESALAMINE4BRCA1
DIPYRIDAMOLE4ATM, BRCA1
CLOTRIMAZOLE4ERBB2
ERLOTINIB HYDROCHLORIDE4ERBB2
PONATINIB4ERBB2, FGFR2
LAPATINIB DITOSYLATE4ERBB2
SORAFENIB4ERBB2, FGFR2
NERATINIB4ERBB2
IBRUTINIB4ERBB2, FGFR2
AFATINIB DIMALEATE4ERBB2
CABOZANTINIB4ERBB2
DACOMITINIB4ERBB2
DACOMITINIB ANHYDROUS4ERBB2
VANDETANIB4ERBB2, FGFR2
TRIBROMSALAN4ERBB2
BOSUTINIB4ERBB2
BITHIONOL4ERBB2, ESR1
ASTEMIZOLE4ERBB2
EBASTINE4ERBB2
OSIMERTINIB4ERBB2
BRIGATINIB4ERBB2, FGFR2
ACALABRUTINIB4ERBB2
ZANUBRUTINIB4ERBB2
TUCATINIB4ERBB2

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)8BRCA1, ERBB2, FGFR2, AKT3, TERT, ESR1, MDM4, ATM
BPhased (≥1) drug, not yet approved1RB1
CDruggable family + PDB, no drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug2BRCA2, PTHLH

Undrugged target profiles

2 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
BRCA20BRCA1
PTHLH0

Clinical trials & evidence

Clinical trials

Clinical trials: 742.

Phase distribution (across all retrieved trials)

PhaseTrials
PHASE2256
PHASE1181
Not specified116
PHASE1/PHASE2106
PHASE359
EARLY_PHASE113
PHASE2/PHASE36
PHASE45

Top trials by phase / activity

NCTPhaseStatusTitle
NCT04790305PHASE4RECRUITINGEffect of Huaier Granule on Adjuvant Treatment for High-risk Early-stage Triple-negative Breast Cancer
NCT05843292PHASE4NOT_YET_RECRUITINGShort-term Sintilimab in Combination With Taxane and Carboplatin for Neoadjuvant Therapy in Triple-negative Breast Cancer
NCT06920810PHASE4RECRUITINGViscum Album for TNBC on Adjuvant Pembrolizumab
NCT02615457PHASE4UNKNOWNHuaier Granule in Treating Women With Triple Negative Breast Cancer
NCT03799679PHASE4UNKNOWNAlbumin-Bound Paclitaxel Followed by Epirubicin in Combination With Cyclophosphamide in Triple Negative Breast Cancer
NCT02445391PHASE3ACTIVE_NOT_RECRUITINGPlatinum in Treating Patients With Residual Triple-Negative Breast Cancer Following Neoadjuvant Chemotherapy
NCT02488967PHASE3ACTIVE_NOT_RECRUITINGDoxorubicin Hydrochloride and Cyclophosphamide Followed by Paclitaxel With or Without Carboplatin in Treating Patients With Triple-Negative Breast Cancer
NCT02641847PHASE2/PHASE3ACTIVE_NOT_RECRUITINGTA(E)C-GP Versus A(E)C-T for the High Risk TNBC Patients and Validation of the mRNA-lncRNA Signature
NCT02954874PHASE3ACTIVE_NOT_RECRUITINGTesting MK-3475 (Pembrolizumab) as Adjuvant Therapy for Triple Receptor-Negative Breast Cancer
NCT03168880PHASE3ACTIVE_NOT_RECRUITINGA Randomized Controlled Trial of Neoadjuvant Weekly Paclitaxel Versus Weekly Paclitaxel Plus Weekly Carboplatin In Women With Large Operable or Locally Advanced, Triple Negative Breast Cancer
NCT03281954PHASE3ACTIVE_NOT_RECRUITINGClinical Trial of Neoadjuvant Chemotherapy With Atezolizumab or Placebo in Patients With Triple-Negative Breast Cancer Followed After Surgery by Atezolizumab or Placebo
NCT03562637PHASE3ACTIVE_NOT_RECRUITINGStudy of Adagloxad Simolenin (OBI-822)/OBI-821 in the Adjuvant Treatment of Patients With Globo H Positive TNBC
NCT03671044PHASE3RECRUITINGA Study to Evaluate the Efficacy and Safety of Nanosomal Docetaxel Lipid Suspension in Triple Negative Breast Cancer Patients
NCT04296175PHASE3ACTIVE_NOT_RECRUITINGCarboplatin Intensified Chemotherapy for TRIple NEgative Breast Cancer(CITRINE)
NCT04301739PHASE3NOT_YET_RECRUITINGto Evaluate Efficacy and Safety of HLX10 in Combination With Chemotherapy Versus Placebo in Combination With Chemotherapy as Neoadjuvant Therapy and HLX10 Versus Placebo as Adjuvant Therapy in Patients With Triple Negative Breast Cancer (TNBC)
NCT04595565PHASE3ACTIVE_NOT_RECRUITINGSacituzumab Govitecan in Primary HER2-negative Breast Cancer
NCT04722978PHASE3RECRUITINGStandard Chemotherapy Plus Moxifloxacin as First-line Treatment for Metastatic Triple-negative Breast Cancer
NCT05078047PHASE3RECRUITINGStudy Comparing the Standard Administration of IO Versus the Same IO Administered Each 3 Months in Patients in Response After 6 Months of Standard IO
NCT05347134PHASE3ACTIVE_NOT_RECRUITINGSKB264 Injection vs Investigator Selected Regimens to Treat Locally Advanced, Recurrent or Metastatic Triple-negative Breast Cancer
NCT05382286PHASE3ACTIVE_NOT_RECRUITINGStudy of Sacituzumab Govitecan-hziy and Pembrolizumab Versus Treatment of Physician’s Choice and Pembrolizumab in Patients With Previously Untreated, Locally Advanced Inoperable or Metastatic Triple-Negative Breast Cancer
NCT05382299PHASE3ACTIVE_NOT_RECRUITINGStudy of Sacituzumab Govitecan-hziy Versus Treatment of Physician’s Choice in Patients With Previously Untreated Locally Advanced Inoperable or Metastatic Triple-Negative Breast Cancer
NCT05552001PHASE3RECRUITINGSafety and Efficacy Analysis of an Antibody Associated With a Chemotherapy for Patients With a Triple Negative Metastatic Breast Cancer
NCT05633654PHASE3RECRUITINGStudy of Sacituzumab Govitecan-hziy and Pembrolizumab Versus Treatment of Physician’s Choice in Patients With Triple Negative Breast Cancer Who Have Residual Invasive Disease After Surgery and Neoadjuvant Therapy (ASCENT-05/AFT-65 OptimICE-RD/GBG 119/NSABP B-63)
NCT05760378PHASE3RECRUITINGFamitinib in Combination With Camrelizumab and TPC in The First-line Treatment of Immunomodulatory Locally Advanced or Metastatic TNBC.
NCT05806060PHASE3RECRUITINGPrecise Treatment for BLIS Subtype of TNBC in the First-line Treatment of Locally Advanced or Metastatic Breast Cancer
NCT05909332PHASE3RECRUITINGStudy of Antivascular Therapy Combined With Chemotherapy Versus Chemotherapy in Adjuvant Therapy of TNBC-BLIS Patients (BCTOP-T-A03)
NCT05954442PHASE3RECRUITINGEverolimus With Investigator’s Choice of Chemotherapy in Advanced Triple-Negative Breast Cancer (TNBC) With Luminal Androgen Receptor (LAR) Subtype
NCT06081244PHASE3RECRUITINGNeoAdj. Therapy Comparing Sacituzumab Govitecan (SG) vs. SG+Pembrolizumab in Low-risk, Triple-neg. EBC (ADAPT-TN-III)
NCT06279364PHASE3RECRUITINGA Study of SKB264 Versus Investigator’s Choice Chemotherapy in Patients With Unresectable Recurrent or Metastatic Triple-Negative Breast Cancer
NCT06382142PHASE3ACTIVE_NOT_RECRUITINGA Study Comparing BL-B01D1 With Chemotherapy of Physician’s Choice in Patients With Unresectable Locally Advanced or Metastatic Triple-Negative Breast Cancer(PANKU-Breast02)
NCT06393374PHASE3RECRUITINGSacituzumab Tirumotecan (MK-2870) Plus Pembrolizumab Versus TPC in TNBC Who Did Not Achieve pCR (MK-2870-012)
NCT06419621PHASE3RECRUITINGPM8002 or Placebo Plus Nab-Paclitaxel as First-line Treatment in Inoperable Locally Advanced/Metastatic TNBC
NCT06519370PHASE3ACTIVE_NOT_RECRUITINGFDA018-ADC vs Investigator’s Choice Chemotherapy to Treat Locally Advanced, Recurrent or Metastatic Triple-negative Breast Cancer
NCT06533384PHASE3RECRUITINGPARPi or Capecitabine Combined With PD-1 Inhibitors as Adjuvant Therapy in High-risk TNBC
NCT06606730PHASE3RECRUITINGPersonalizing the Use of Pembrolizumab for Patients Who Have a Strong Response in Early Triple Negative Breast Cancer
NCT06732323PHASE3RECRUITINGA Phase III Study of ESG401 for Unresectable Recurrent or Metastatic Triple-Negative Breast Cancer
NCT06767527PHASE3RECRUITINGAK112 or Placebo Plus Nab-Paclitaxel as First-line Treatment in Inoperable Locally Advanced/ Metastatic Triple-negative Breast Cancer
NCT06795503PHASE3NOT_YET_RECRUITINGNon-Inferiority Study on MRNA-lncRNA Model in Low-Risk Triple-Negative Breast Cancer Patients
NCT06889688PHASE3RECRUITINGPhase III Trial of Camrelizumab+Apatinib+Eribulin vs. Physician’s Choice Chemotherapy in Advanced Triple-Negative Breast Cancer
NCT06910072PHASE2/PHASE3NOT_YET_RECRUITINGPaclitaxel Polymeric Micelles and Carboplatin in Combination With Iparomilimab and Tuvonralimab Neoadjuvant Therapy for Triple-negative Breast Cancer

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
CARBOPLATIN484
ERIBULIN420
SACITUZUMAB GOVITECAN416
ATEZOLIZUMAB47
EPIRUBICIN47
OLAPARIB46
TRILACICLIB44
VINORELBINE44
TALAZOPARIB43
GEMCITABINE HYDROCHLORIDE42
NIRAPARIB42
PEMBROLIZUMAB42
SELUMETINIB42
TORIPALIMAB42
AFATINIB41
FLUDEOXYGLUCOSE F 1841
PEGFILGRASTIM41
ROMIDEPSIN41
TIVOZANIB HYDROCHLORIDE41
TRAMETINIB41
TREMELIMUMAB41
VELIPARIB321
SPARTALIZUMAB39
SACITUZUMAB TIRUMOTECAN35
CAMRELIZUMAB34
FAMITINIB34
RIVOCERANIB34
ENTINOSTAT33
IPATASERTIB33
IVONESCIMAB33

Precision-medicine subtype map (CIViC)

Drug × molecular subtype: 19 predictive associations from 19 curated evidence items.

Molecular subtypeTherapyEffectLevelCIViC
BRCA1 Loss-of-functionOlaparibSensitivity/ResponseCIViC AEID11216
BRCA2 Loss-of-functionOlaparibSensitivity/ResponseCIViC AEID11217
BRCA1 MutationCisplatin + CarboplatinSensitivity/ResponseCIViC BEID1684
BRCA2 MutationCarboplatin + CisplatinSensitivity/ResponseCIViC BEID1685
BRCA2 MutationOlaparibSensitivity/ResponseCIViC BEID1776
CD274 AmplificationDurvalumabSensitivity/ResponseCIViC BEID12054
CDK2 CYTOPLASMIC EXPRESSIONEribulin + CarboplatinSensitivity/ResponseCIViC BEID2969
BRCA1 MutationOlaparibResistanceCIViC BEID1775
TACSTD2 T256RSacituzumab GovitecanResistanceCIViC BEID12265
ERBB2 L755SCapecitabine + NeratinibSensitivity/ResponseCIViC CEID8055
FGFR2 AmplificationFutibatinibSensitivity/ResponseCIViC CEID11648
TOP1 E418K AND TOP1 -122fsSacituzumab GovitecanResistanceCIViC CEID12266
PTPN12 Loss-of-functionSunitinib + CrizotinibSensitivity/ResponseCIViC DEID6931
RB1 Loss-of-functionGemcitabineSensitivity/ResponseCIViC DEID12329
RB1 Loss-of-functionCheckpoint Kinase Inhibitor AZD7762Sensitivity/ResponseCIViC DEID12330
RB1 Loss-of-functionVolasertibSensitivity/ResponseCIViC DEID12331
XRCC3 Mutation OR ORC1 MutationCisplatinSensitivity/ResponseCIViC DEID11716
AKT3 OverexpressionPan-AKT Kinase Inhibitor GSK690693Sensitivity/ResponseCIViC EEID1923
TMB HighImmune Checkpoint InhibitorCIViC EEID12950