Abstract
In recent decades, breast cancer has become largely manageable due to successes with hormone receptor targeting. Hormone receptor-positive tumors have favorable outcomes in comparison to estrogen receptor (ESR1, ER)/progesterone receptor-negative tumors given the targetable nature of these tumors, as well as their inherently less aggressive character. Nonetheless, treatment resistance is frequently encountered due to a variety of mechanisms, including ESR1 mutations and loss of ER expression. A new era of precision medicine utilizes a range of methodologies to allow real-time analysis of individual genomic signatures in metastases and liquid biopsies with the goal of finding clinically actionable targets. Preliminary studies have shown improved progression-free survival and overall survival with implementation of this information for clinical decision making. In this review, we will discuss the opportunities and challenges in integrating precision medicine through next-generation genomic sequencing into the management of breast cancer.
Highlights
Reviewed by: Tami Rubinek, Tel Aviv Sourasky Medical Center, Israel Ann M
In large part excellent outcomes can be attributed to successes with targeting hormone receptors in hormone receptor-positive disease, which comprises 83% of invasive breast cancers according to recent data [1]
In patients with HER2-positive metastatic breast cancer (MBC), trastuzumab in combination with standard chemotherapy demon strated a clear benefit in time to progression, duration of response, and overall survival (OS) as compared to chemotherapy alone [46]
Summary
Reviewed by: Tami Rubinek, Tel Aviv Sourasky Medical Center, Israel Ann M. Meta-analyses of 15 years follow-up data from randomized trials of patients with ER-positive disease given 5-year adjuvant tamoxifen after 6 months of anthracycline-based chemotherapy have demonstrated an approximately 50% reduction in breast cancer mortality [8].
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