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乳腺癌精准医学的当前生物标志物

Current Biomarkers for Precision Medicine in Breast Cancer.

作者信息

Ahn Soo Kyung, Jung So-Youn

机构信息

Breast and Thyroid Center, Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University, Seoul, South Korea.

Center for Breast Cancer, National Cancer Center, Goyang-si, South Korea.

出版信息

Adv Exp Med Biol. 2021;1187:363-379. doi: 10.1007/978-981-32-9620-6_18.

Abstract

Breast cancer has become the prototypical solid tumor where targets have been identified within the tumor allowing for personalized approach for systemic therapy. Biomarkers are beginning to play an important role in preparing the way for precision treatment. Mandatory biomarkers for every newly diagnosed case of breast cancer are estrogen receptors and progesterone receptors in selecting patients for endocrine treatment and HER2 for identifying patients likely to benefit from antiHER2 therapy. Although methodological problems exist in the determination of Ki67, because of its clearly established clinical value, wide availability, and low costs relative to the available multianalyte signatures, Ki67 may be used for determining prognosis, especially if values are low or high. Also, the androgen receptor (AR) pathway is emerging as a potential therapeutic target in breast cancer. AR-targeted treatments for breast cancer are in development and have shown promising preliminary results. While, most established biomarkers in breast cancer require tissue samples, serum tumor markers are easily accessible and require a less invasive procedure. Among them, tissue polypeptide-specific antigen (TPS), a specific epitope structure of a peptide in serum associated with human cytokeratin 18, is linked to the proliferative activity of tumors. TPS may be a valuable and independent prognostic biomarker for breast cancer.In order to accelerate progress towards precision treatment for women with breast cancer, we need additional predictive biomarker, especially for enhancing the positive predictive value for endocrine and antiHER2 therapies, as well as biomarkers for predicting response to specific forms of chemotherapy.

摘要

乳腺癌已成为典型的实体瘤,在肿瘤内部已确定了靶点,从而能够采取个性化的全身治疗方法。生物标志物开始在为精准治疗铺平道路方面发挥重要作用。对于每一例新诊断的乳腺癌病例,在选择内分泌治疗的患者时,雌激素受体和孕激素受体以及用于识别可能从抗HER2治疗中获益的患者的HER2是必需的生物标志物。尽管在Ki67的测定中存在方法学问题,但由于其明确的临床价值、广泛的可及性以及相对于可用的多分析物特征较低的成本,Ki67可用于判断预后,尤其是当数值较低或较高时。此外,雄激素受体(AR)通路正在成为乳腺癌潜在的治疗靶点。针对乳腺癌的AR靶向治疗正在研发中,并已显示出有前景的初步结果。虽然,乳腺癌中大多数已确立的生物标志物需要组织样本,但血清肿瘤标志物易于获取且所需的侵入性操作较少。其中,组织多肽特异性抗原(TPS),一种血清中与人类细胞角蛋白18相关的肽的特异性表位结构,与肿瘤的增殖活性相关。TPS可能是乳腺癌一种有价值的独立预后生物标志物。为了加快乳腺癌女性精准治疗的进展,我们需要更多的预测性生物标志物,尤其是用于提高内分泌和抗HER2治疗的阳性预测值,以及用于预测对特定形式化疗反应的生物标志物。

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