Breast cancer: from guidelines to personalized oncology


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Abstract

The review considers the present-day problems and possibilities of targeted therapy for breast cancer (BC) in relation to the biological subtype of a tumor. The emergence of new clinical data on the targeted drugs and their combinations already used in routine practice and new medications from an arsenal of personalized medicine leads to changes in therapeutic approaches. The review gives great attention to the HER2-positive subtype of BC.There is evidence from clinical trials of pertuzumab and T-DM1, which may alter the standard treatment for HER2-positive BC. The review also considers the predictive value of the recurrence index in the luminal subtype and biological characteristics of triple negative BC.

About the authors

Conte PierFranco

Университетская клиника г. Падуя, Италия

Guarneri Valentina

Университетская клиника г. Падуя, Италия

References

  1. Goldhirsch A. Strategies for subtypes – dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer. Ann Oncol 2011; 22 (8): 1736–47.
  2. Paik S et al. A Multigene Assay to Predict Recurrence of Tamoxifen - Treated, Node - Negative Breast Cancer. NEJM 2004; 351 (27): 2817.
  3. Paik S et al. Gene expression and benefit of chemotherapy in women with node - negative, estrogen receptor - positive breast cancer. J Clin Oncol 2006; 24 (23): 3726–34.
  4. NCCN guidelines. Version 2; 2011.
  5. Ismael G et al. Subcutaneous versus intravenous administration of (neo) adjuvant trastuzumab in patients with HER2-positive, clinical stage I–III breast cancer (HannaH study): a phase 3, open - label, multicentre, randomised trial. Lancet Oncol 2012; 13 (9): 869–78.
  6. Gianni L et al. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open - label, phase 2 trial. Lancet Oncol 2012; 13 (1): 25–32.
  7. Baselga J et al. Lapatinib with trastuzumab for HER2-positive early breast cancer (NeoALTTO): a randomised, open - label, multicentre, phase 3 trial. Lancet 2012.
  8. Guarneri V et al. Preoperative Chemotherapy Plus Trastuzumab, Lapatinib, or Both in Human Epidermal Growth Factor Receptor 2-Positive Operable Breast Cancer: Results of the Randomized Phase II CHER-LOB Study. JCO 2012.
  9. Robidoux A et al. Evaluation of lapatinib as a component of neoadjuvant therapy for HER2+ operable breast cancer: NSABP protocol B-41. ASCO 2012; LBA 506.
  10. Baselga J et al. Pertuzumab plus Trastuzumab plus Docetaxel for Metastatic Breast Cancer. N Engl J Med 2012; 366: 109–9.
  11. Swain S et al. Confirmatory overall survival (OS) analysis of CLEOPATRA: A randomized, double blind, placebo - controlled Phase III study with pertuzumab (P), trastuzumab (T), and docetaxel (D) in patients (pts) with HER2-positive first - line (1L) metastatic breast cancer (MBC). Cancer Res 2012; 72 (Suppl. 24).
  12. Hurvitz S.A et al. Trastuzumab Emtansine (T - DM1) Vs Trastuzumab Plus Docetaxel (H+T) in Previously - untreated HER2-positive Metastatic Breast Cancer (MBC): Primary Results of a Randomized, Multicenter, Open - label Phase II Study (TDM4450 g/BO21976). ESMO 2011; Abstr 5001.
  13. Gluz O et al. Triple - negative breast cancer – current status and future directions. Ann Oncol 2009; 20: 1913–27.
  14. Lehmann B.D et al. Identification of human triple - negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Inv 2011; 12 (7): 2750–67.
  15. Gelmon K et al. Targeting triple - negative breast cancer: optimizing therapeutic outcomes. Ann Oncol 2012; 23 (9): 2223–34.
  16. Romond E.H et al. Seven - year follow - up assessment of cardiac function in nsabp b-31, a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel (acp) with acp plus trastuzumab as adjuvant therapy for patients with node - positive, human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 2012; 30: 3792–9.
  17. Curtis C et al. The genomic and transcriptomic architecture of 2000 breast tumours reveals novel subgroups. Nature 2012; 486: 346–52.
  18. Blackwell K et al. Primary results from EMILIA, a phase III study of trastuzumab emtansine (T - DM1) versus capecitabine and lapatinib in HER2-positive locally advanced or metastatic breast cancer previously treated with trastuzumab and a taxane. ASCO 2012; LBA1.
  19. Verma S et al. Trastuzumab Emtansine for HER2-Positive Advanced Breast Cancer. N Engl J Med 2012; 367: 1783–91.

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