Tailored targeted therapy for all: a realistic and worthwhile objective against

Kathleen I Pritchard

doi:10.1186/bcr2427

Abstract

Tailored targeted therapy for all: a realistic and worthwhile objective against

Highlights

Targeted therapy for breast cancer was used, albeit unwittingly, as early as the late 1800s
Beatson first surgically removed the ovaries of women to treat metastatic breast cancer in 1896 [1], while Schinzinger recommended ovarian irradiation as adjuvant therapy in 1889 [2]
It is known that women whose tumours are ER-negative and progesterone receptor (PgR)-negative have less than a 5% chance of responding to endocrine therapies, while those whose tumours are ER-positive and/or PgR-positive have a chance of response of somewhere between 40 and 70%

Summary

Introduction

Targeted therapy for breast cancer was used, albeit unwittingly, as early as the late 1800s. It was believed that having both receptors positive improved the response rate or benefit from adjuvant endocrine therapy for many years, but is felt that the ER serves as the major predictive factor. A meta-analysis of phase III trials evaluating the predictive value of HER2 and topoisomerase IIα in early breast cancer patients treated with cyclophosphamide, methotrexate and 5-FU (CMF) versus anthracycline-based adjuvant therapy did not show a strongly statistically significant predictive value [26], when the large British NEAT and BR9601 studies were included Targeted anti-HER2 agents such as lapatinib were meant to be effective against HER1 and HER2 overexpressing tumours but have proved to affect only individuals with HER2-positive tumours Newer drugs such as bevacizumab – an antivascular endothelial growth factor antibody – are effective, but one cannot find a target that selects subgroups of patients in whom it is more valuable [29]. I would conclude that tailored targeted therapy for all may be worthwhile but is not yet realistic

Schinzinger A

Early Breast Cancer Trialists’ Collaborative Group

Findings

18. Ellis M