Bringing molecular prognosis and prediction to the clinic.
In the past 30 years, important advances have been made in the knowledge of breast cancer biology and in the treatment of the disease. However, the translation of these advances into clinical practice has been slow. With the advent of molecular-based medicine, it is hoped that the bridge between the bench and the bedside will continue to be shortened. Because breast cancer is a heterogeneous disease with wide-ranging subsets of patients who have different prognoses and who respond differently to treatments, the identification of patients who need treatment and the definition of the best therapy for an individual have become the priorities in breast cancer care. This article will review the crucial role of prognostic and predictive factors in achieving these goals. A critical review of classical and newer individual molecular markers, such as hormone receptors, HER2, urokinase-type plasminogen activator and plasminogen activator inhibitor 1, cyclin E, topoisomerase II, and p53, was performed, and the preliminary results obtained using the new gene expression profiling technology are described along with their potential clinical implications.
Colozza
Mariantonietta
M
S.C. Oncologia Medica, Azienda Ospedaliera, Perugia, Italy. martine.piccart@bordet.be
Cardoso
Fatima
F
Sotiriou
Christos
C
Larsimont
Denis
D
Piccart
Martine J
MJ
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D003131:Combined Modality Therapy; D019927:Cyclin E / Q000032:analysis / Q000378:metabolism; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D008967:Molecular Biology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D018570:Risk Assessment; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D019927:Cyclin E; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen