Abstract

Precision oncology is an emerging approach in cancer care. It aims at selecting the optimal therapy for the right patient by considering each patient’s unique disease and individual health status. In the last years, it has become evident that breast cancer is an extremely heterogeneous disease, and therefore, patients need to be appropriately stratified to maximize survival and quality of life. Gene-expression tools have already positively assisted clinical decision making by estimating the risk of recurrence and the potential benefit from adjuvant chemotherapy. However, these approaches need refinement to further reduce the proportion of patients potentially exposed to unnecessary chemotherapy. Nuclear magnetic resonance (NMR) metabolomics has demonstrated to be an optimal approach for cancer research and has provided significant results in BC, in particular for prognostic and stratification purposes. In this review, we give an update on the status of NMR-based metabolomic studies for the biochemical characterization and stratification of breast cancer patients using different biospecimens (breast tissue, blood serum/plasma, and urine).

Highlights

  • Magnetic Resonance Center (CERM), University of Florence, 50019 Sesto Fiorentino, Italy; Department of Chemistry “Ugo Schiff”, University of Florence, 50019 Sesto Fiorentino, Italy

  • Called personalized medicine, is an emerging approach for disease treatment and prevention that takes into account genetics, epigenetics, metabolism, environment, and lifestyle of each individual person with the goal to select the optimal therapy for the right patient

  • These two groups of patients can be discriminated by Nuclear magnetic resonance (NMR) metabolomics with high accuracy, and as reported in Table 4, several metabolites showed statistically different levels in patients with early breastbenefit cancerfrom (EBC) and metastatic breast cancer (MBC), implying a progressive disruption and rewiring of several metabolic pathways following the evolution of the disease

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Summary

Breast Cancer

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Besides small metabolites, serum and plasma contain lipoproteins that with appropriate software (i.e., the Bruker IVDr platform) can be finely analyzed to derive, from serum and plasma NMR spectra, about 100 different lipid parameters that describe the distribution and analytical composition of lipid main fractions and subclasses [64] This is especially important in the lipidomics domain, because the composition of lipoproteins has a strong influence on disease development, including BC [65]. We will present an overview on the current status of NMR-based metabolomics studies in the setting of breast cancer using three different biological samples: breast tissue, serum/plasma and urine (Figure 2, Table 1).

NMR Metabolomics
77 BC an association with higher
Correlation with Response to Neoadjuvant Therapy
Correlation with Survival
Correlation with Transcriptomics and Proteomics
Correlation with Quantitative Conventional Breast Imaging
Characterization of the Metabolomics Profile of BC Patients
Blood Metabolomics
Pharmacometabolomics in Breast Cancer Setting
NMR Lipidomics in Breast Cancer
NMR Metabolomics of Urine
Translation of NMR-Based Metabolomics in Clinics
Findings
Conclusions
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