Abstract
PurposeThere are numerous biomarkers which may have potential predictive and prognostic significance in breast cancer. This is extremely important in older adults, who may opt for less aggressive therapy. This work outlines the literature on biological assessment outside of standard biomarkers (defined as ER, PgR, HER2, Ki67) in women ≥ 65 years with primary operable invasive breast cancer, to determine which additional biomarkers are relevant to outcome in older women.MethodsMedline and Embase databases were searched. Studies were eligible if included ≥ 50 patients aged ≥ 65 years; stratified results by age; measured a biomarker outside of standard assay and reported patient data.ResultsA total of 12 studies were appraised involving 5000 patients, measuring 28 biomarkers. The studies were extremely varied in methodology and outcome but three themes emerged: 1. Differences in biomarker expression between younger and older women, indicating that breast cancer in older women is generally less aggressive compared to younger women; 2. Relationship of biomarker expression with survival, suggesting biomarkers which may exclusively predict response to primary treatment in older women; 3. Association of biomarker with chemotherapy, suggesting that older patients should not be declined chemotherapy based on age alone.ConclusionThere is evidence to support further investigation of B-cell lymphoma (BCL2), liver kinase (LK)B1, epidermal growth factor receptor (EGFR), cytoplasmic cyclin-E, mucin (MUC)1 and cytokeratins (CKs) as potential predictive or prognostic markers in older women with breast cancer undergoing surgery. Studies exploring these biomarkers in larger cohorts and in women undergoing non-operative therapies are required.
Highlights
+ ve Positive − ve Negative AIB Amplified in breast cancer alcohol dehydrogenase (ALDH) Aldehyde dehydrogenase AR Androgen receptor BCL B-cell lymphoma BCS Breast conserving surgery breast cancer specific survival (BCSS) Breast cancer specific survival breast cancer gene (BRCA) Breast cancer gene CA Conference abstract CDH Chromodomain helicase DNA CEA Carcinoembryonic antigen binding protein
PgR Progesterone receptor PFS Progression free survival phosphatase and tensin homolog (PTEN) Phosphatase and tensin homolog RANTES Regulated upon activation, normal T cell expressions and presumably secreted RS Recurrence score RUNX Runt-related transcription factor tumour necrosis factor (TNF) Tumour necrosis factor translocator protein (TP) Translocator protein TP53 Tumour suppressor gene p53 TYPMS Thymidine phosphorylase U Unknown vascular endothelial growth factor (VEGF) Vascular endothelial growth factor
There is an evidence base for the importance of biomarkers outside those currently measured in clinical practice, in breast cancer in older women, compared to younger women
Summary
+ ve Positive − ve Negative AIB Amplified in breast cancer ALDH Aldehyde dehydrogenase AR Androgen receptor BCL B-cell lymphoma BCS Breast conserving surgery BCSS Breast cancer specific survival BRCA Breast cancer gene CA Conference abstract CDH Chromodomain helicase DNA CEA Carcinoembryonic antigen binding protein. CK Cytokeratin EGFR Epidermal growth factor receptor ER Oestrogen receptor FP Full paper IGF Insulin-like growth factor IL Interleukin HER Human epidermal growth factor receptor HRD Homologous recombination deficiency KMT2C Lysine methytransferase LK Liver kinase MAP2K Mitogen-activated protein kinase MCP Methyl-accepting chemotaxis protein Mx Mastectomy MUC Mucin N Number NAHT Neoadjuvant hormonal therapy NCOR Nuclear receptor corepressor NF Normal function PAI Plasminogen activator inhibitor. PgR Progesterone receptor PFS Progression free survival PTEN Phosphatase and tensin homolog RANTES Regulated upon activation, normal T cell expressions and presumably secreted RS Recurrence score RUNX Runt-related transcription factor TNF Tumour necrosis factor TP Translocator protein TP53 Tumour suppressor gene p53 TYPMS Thymidine phosphorylase U Unknown VEGF Vascular endothelial growth factor. The aim of this work is to review the evidence base for biological markers outside of those routinely measured in clinical practice and avenues for future research
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call