title: Adjuvant chemotherapy: which patient? What regimen?
abstract: In the past, treatment decisions regarding adjuvant chemotherapy in early breast cancer (EBC) were made solely based on clinicopathologic factors. However, with increased awareness of the importance of underlying tumor biology, we are now able to use genomic analyses to determine molecular breast cancer subtype and thus identify patients with tumors that are chemotherapy resistant and unlikely to benefit from the addition of chemotherapy. Although genomics has allowed some patients to avoid chemotherapy-specifically those with luminal A-like breast cancer-these assays do not indicate which regimen is most appropriate. For this, consideration must be given to the combination of underlying tumor biology, tumor stage, and patient characteristics, such as age and tolerability of side effects.
authors.affiliation: From the Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy; Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy.
authors.forename: Natalie
authors.initials: N
authors.lastname: Turner
authors.forename: Laura
authors.initials: L
authors.lastname: Biganzoli
authors.forename: Luca
authors.initials: L
authors.lastname: Malorni
authors.forename: Ilenia
authors.initials: I
authors.lastname: Migliaccio
authors.forename: Erica
authors.initials: E
authors.lastname: Moretti
authors.forename: Marta
authors.initials: M
authors.lastname: Pestrin
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Sanna
authors.forename: Olimpia
authors.initials: O
authors.lastname: Siclari
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Leo
mesh_terms: D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D002277:Carcinoma / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D016678:Genome; D006801:Humans; D007150:Immunohistochemistry; D018579:Patient Selection; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human