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液体活检指导人表皮生长因子受体 2 阳性乳腺癌患者管理:精准医学的未来。

Modeling the management of patients with human epidermal growth factor receptor 2-positive breast cancer with liquid biopsy: the future of precision medicine.

机构信息

Department of Medicine, Division of Hematology-Oncology, Weill Cornell Medicine, New York, New York, USA.

Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola.

出版信息

Curr Opin Oncol. 2024 Nov 1;36(6):503-513. doi: 10.1097/CCO.0000000000001082. Epub 2024 Jul 15.

DOI:10.1097/CCO.0000000000001082
PMID:39011731
Abstract

PURPOSE OF REVIEW

In the evolving landscape of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) management, liquid biopsy offers unprecedented opportunities for guiding clinical decisions. Here, we review the most recent findings on liquid biopsy applications in HER2-positive BC and its potential role in addressing challenges specific to this BC subtype.

RECENT FINDINGS

Recent studies have highlighted the significance of liquid biopsy analytes, primarily circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs), in stratifying patients' prognosis, predicting treatment response, and monitoring tumor evolution in both early and advanced stages of BC. Liquid biopsy holds promise in studying minimal residual disease to detect and potentially treat disease recurrence before it manifests clinically. Additionally, liquid biopsy may have significant implication in the management of brain metastasis, a major challenge in HER2-positive BC, and could redefine parameters for determining HER2 positivity. Combining ctDNA and CTCs is crucial for a comprehensive understanding of HER2-positive tumors, as they provide complementary insights.

SUMMARY

Research efforts are needed to address analytical challenges, validate, and broaden the application of liquid biopsy in HER2-positive BC. This effort will ultimately facilitate its integration into clinical practice, optimizing the care of patients with HER2-positive tumors.

摘要

目的综述

在人表皮生长因子受体 2(HER2)阳性乳腺癌(BC)管理的不断发展的领域中,液体活检为指导临床决策提供了前所未有的机会。在这里,我们回顾了液体活检在 HER2 阳性 BC 中的最新应用及其在解决该 BC 亚型特定挑战方面的潜在作用。

最近的发现

最近的研究强调了液体活检分析物的重要性,主要是循环肿瘤 DNA(ctDNA)和循环肿瘤细胞(CTC),可用于分层患者的预后,预测治疗反应,并监测 BC 的早期和晚期阶段的肿瘤演变。液体活检在研究微小残留疾病方面具有很大的潜力,可在疾病临床出现之前检测并可能治疗疾病复发。此外,液体活检在管理 HER2 阳性 BC 中的主要挑战——脑转移方面具有重要意义,并可能重新定义确定 HER2 阳性的参数。ctDNA 和 CTCs 的结合对于全面了解 HER2 阳性肿瘤至关重要,因为它们提供了互补的见解。

总结

需要研究努力来解决分析挑战,验证并拓宽液体活检在 HER2 阳性 BC 中的应用。这一努力最终将促进其纳入临床实践,优化 HER2 阳性肿瘤患者的护理。

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