Toss Angela, Cristofanilli Massimo
Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, 41125, Italy.
Department of Medical Oncology, Jefferson University Hospital, 1100 Walnut Street, Philadelphia, PA, 19107, USA.
Breast Cancer Res. 2015 Apr 23;17(1):60. doi: 10.1186/s13058-015-0560-9.
Despite the wide improvements in breast cancer (BC) detection and adjuvant treatment, BC is still responsible for approximately 40,000 deaths annually in the United States. Novel biomarkers are fundamental to assist clinicians in BC detection, risk stratification, disease subtyping, prediction of treatment response, and surveillance, allowing a more tailored approach to therapy in both primary and metastatic settings. In primary BC, the development of molecular profiling techniques has added prognostic and predictive information to conventional biomarkers--estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. Moreover, the application of next-generation sequencing and reverse-phase protein microarray methods in the metastatic setting holds the promise to further advance toward a personalized management of cancer. The improvement in our understanding on BC biology associated with the study of the genomic aberrations characterizing the most common molecular subtypes allows us to explore new targets for drug development. Finally, the integration of cancer stem cell-targeted therapies and immune therapies in future combination regimens increases our chances to successfully treat a larger proportion of women with more aggressive and resistant metastatic disease. This article reviews the current state of novel biological markers for BC, the evidence to demonstrate their clinical validity and utility, and the implication for therapeutic targeting.
尽管乳腺癌（BC）检测和辅助治疗有了广泛改进，但在美国，乳腺癌每年仍导致约40,000人死亡。新型生物标志物对于协助临床医生进行乳腺癌检测、风险分层、疾病亚型分类、治疗反应预测及监测至关重要，从而在原发性和转移性疾病中实现更具针对性的治疗方法。在原发性乳腺癌中，分子谱分析技术的发展为传统生物标志物——雌激素受体、孕激素受体和人表皮生长因子受体2增添了预后和预测信息。此外，下一代测序和反相蛋白质微阵列方法在转移性疾病中的应用有望进一步推动癌症的个性化管理。我们对乳腺癌生物学的理解因对表征最常见分子亚型的基因组畸变的研究而得到改善，这使我们能够探索新的药物开发靶点。最后，在未来的联合治疗方案中整合针对癌症干细胞的疗法和免疫疗法，增加了我们成功治疗更大比例患有更具侵袭性和耐药性转移性疾病女性的机会。本文综述了乳腺癌新型生物标志物的现状、证明其临床有效性和实用性的证据以及对治疗靶点的影响。
