Department of Medical Oncology, Dubai Hospital, Dubai, UAE.
Cancer Biomark. 2012;12(6):241-50. doi: 10.3233/CBM-130315.
With the increasing use of neoadjuvant chemotherapy it is increasingly being observed that differences in the status of molecular markers may exist between core biopsy specimens and the residual disease in the breast post chemotherapy. Several hypotheses have been postulated to explain the biomarker discordance observed following neoadjuvant chemotherapy including intratumor heterogeneity, technical variance in the assays used to assess biomarkers and a genetic switch in the biology of the disease. Here we review published data looking at discordance of biomarkers following neoadjuvant chemotherapy and the prognostic and therapeutic implications of the observed discordance. We will review some of the biological explanations to account for the observed discordance and will look at its impact on the role of the pathologist as well as propose essential components required in a pathology report issued for patients receiving neoadjuvant chemotherapy that would help the medical oncologist in treatment planning.
随着新辅助化疗的应用日益增多，人们越来越多地观察到，核心活检标本与化疗后乳房残留疾病之间的分子标志物状态可能存在差异。已经提出了几种假设来解释新辅助化疗后观察到的生物标志物不一致，包括肿瘤内异质性、用于评估生物标志物的检测技术差异以及疾病生物学中的遗传转换。在这里，我们回顾了已发表的数据，探讨了新辅助化疗后生物标志物的不一致性以及观察到的不一致性的预后和治疗意义。我们将回顾一些生物学解释，以说明观察到的不一致性，并探讨其对病理学家角色的影响，同时提出接受新辅助化疗的患者的病理报告中需要包含的基本内容，这将有助于肿瘤内科医生制定治疗计划。
