OncoPharma Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal.
Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Int J Mol Sci. 2022 Mar 16;23(6):3181. doi: 10.3390/ijms23063181.
Breast cancer is classified into four major molecular subtypes, and is considered a heterogenous disease. The risk profiles and treatment of breast cancer differ according to these subtypes. Early detection dramatically improves the prospects of successful treatment, resulting in a reduction in overall mortality rates. However, almost 30% of women primarily diagnosed with the early-stage disease will eventually develop metastasis or resistance to chemotherapies. Immunotherapies are among the most promising cancer treatment options; however, long-term clinical benefit has only been observed in a small subset of responding patients. The current strategies for diagnosis and treatment rely heavily on histopathological examination and molecular diagnosis, disregarding the tumor microenvironment and microbiome involving cancer cells. In this review, we aim to praise the use of pharmacogenomics and pharmacomicrobiomics as a strategy to identify potential biomarkers for guiding and monitoring therapy in real-time. The finding of these biomarkers can be performed by studying the metabolism of drugs, more specifically, immunometabolism, and its relationship with the microbiome, without neglecting the information provided by genetics. A larger understanding of cancer biology has the potential to improve patient care, enable clinical decisions, and deliver personalized medicine.
乳腺癌分为四个主要的分子亚型，被认为是一种异质性疾病。根据这些亚型，乳腺癌的风险特征和治疗方法也有所不同。早期发现可显著提高成功治疗的前景，从而降低总体死亡率。然而，近 30%的女性最初被诊断为早期疾病，最终仍会发展为转移或对化疗产生耐药性。免疫疗法是最有前途的癌症治疗选择之一；然而，只有一小部分有反应的患者观察到了长期的临床获益。目前的诊断和治疗策略主要依赖于组织病理学检查和分子诊断，而忽略了涉及癌细胞的肿瘤微环境和微生物组。在这篇综述中，我们旨在赞扬将药物基因组学和药物微生物组学作为一种策略来识别潜在的生物标志物，以实时指导和监测治疗。这些生物标志物的发现可以通过研究药物代谢，更具体地说，免疫代谢及其与微生物组的关系来实现，同时也不应忽视遗传学提供的信息。对癌症生物学有更深入的了解有可能改善患者护理，使临床决策更加明智，并提供个性化医疗。
