Service of Oncology, Hospital La Paz & Instituto de Investigación Sanitaria IdiPAZ, Paseo de la Castellana, Madrid, Spain.
Cancer Treat Rev. 2011 Oct;37(6):416-21. doi: 10.1016/j.ctrv.2010.12.009. Epub 2011 Feb 1.
Gene signatures may complement clinical and pathological factors to predict prognosis and response to therapy in patients with breast cancer, and can also sub-classify these tumours into entities with different biology and treatment requirements. A number of prognostic gene signatures are commercially available at this moment and two of them have entered phase III evaluation. Specific signatures are also being assessed to predict response to a number of drug therapies. The combined use of prognostic, predictive and subtype-defining signatures will guide therapeutic decisions in the future and will facilitate development of targeted drugs in specific groups of patients. However, cost-utility issues and some technical limitations have hindered widespread adoption of gene profiling. Gene signatures will become part of the routine clinical workup only if they help making clinical decisions. The first step to achieve this will consist of the inclusion of gene signatures in the design of clinical trials with new drugs.
基因标志物可以补充临床和病理因素，以预测乳腺癌患者的预后和对治疗的反应，也可以将这些肿瘤进一步细分为具有不同生物学和治疗需求的实体。目前有许多预后基因标志物已商业化，其中有两个已进入 III 期评估。还在评估特定的标志物来预测对多种药物治疗的反应。预后、预测和亚型定义标志物的联合使用将指导未来的治疗决策，并有助于在特定患者群体中开发靶向药物。然而，成本效益问题和一些技术限制阻碍了基因谱分析的广泛应用。只有当基因标志物有助于做出临床决策时，它们才会成为常规临床检查的一部分。实现这一目标的第一步将包括在新药临床试验的设计中纳入基因标志物。
