Unmet Clinical Need: Developing Prognostic Biomarkers and Precision Medicine to Forecast Early Tumor Relapse, Detect Chemo-Resistance and Improve Overall Survival in High-Risk Breast Cancer.
Unmet Clinical Need: Developing Prognostic Biomarkers and Precision Medicine to Forecast Early Tumor Relapse, Detect Chemo-Resistance and Improve Overall Survival in High-Risk Breast Cancer.
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DOI：
10.36959/739/525
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发表时间：
2020-05-02
期刊：
影响因子：
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通讯作者：
Tang, Amy H
中科院分区：
文献类型：
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作者：
Gupta, Gagan;Lee, Caroline Dasom;Tang, Amy H
耐药性乳腺癌是相当多的乳腺癌妇女接受治愈性治疗的主要障碍。新辅助化疗（NACT）是大多数诊断为高危TNBC、HER2+和局部晚期ER+乳腺癌的女性的标准一线治疗。目前的临床预后工具评估四个临床病理因素：肿瘤大小，LN状态，病理分期和肿瘤分子亚型。然而，许多在NACT后具有相同残留癌症负荷（RCB）的类似治疗的患者经历了明显不同的肿瘤复发率、临床结局和生存期。对于NACT后具有高风险RCB分类的不完全应答者，该问题尤其明显。因此，迫切需要鉴定新的预后和预测生物标志物，并开发新的治愈性疗法以增强当前的标准护理（SOC）治疗方案以挽救更多的生命。在这里，我们将讨论这些未满足的需求和临床挑战，这些挑战阻碍了精准医学和个性化癌症治疗。
Chemo-resistant breast cancer is a major barrier to curative treatment for a significant number of women with breast cancer. Neoadjuvant chemotherapy (NACT) is standard first- line treatment for most women diagnosed with high-risk TNBC, HER2+, and locally advanced ER+ breast cancer. Current clinical prognostic tools evaluate four clinicopathological factors: Tumor size, LN status, pathological stage, and tumor molecular subtype. However, many similarly treated patients with identical residual cancer burden (RCB) following NACT experience distinctly different tumor relapse rates, clinical outcomes and survival. This problem is particularly apparent for incomplete responders with a high-risk RCB classification following NACT. Therefore, there is a pressing need to identify new prognostic and predictive biomarkers, and develop novel curative therapies to augment current standard of care (SOC) treatment regimens to save more lives. Here, we will discuss these unmet needs and clinical challenges that stand in the way of precision medicine and personalized cancer therapy.