title: Pharmacogenetics and breast cancer management: current status and perspectives.
abstract: BACKGROUND
  Breast cancer has benefited from a number of innovative therapeutics over the last decade. Cytotoxics, hormone therapy, targeted therapies and biologics can now be given to ensure optimal management of patients. As life expectancy of breast cancer patients has been significantly stretched and that several lines of treatment are now made available, determining the best drug or drug combinations to be primarily given and the best dosing and scheduling for each patient is critical for ensuring an optimal toxicity/efficacy balance.
  
  
  METHODS
  Defining patient's characteristics at the tumor level (pharmacogenomics) and the constitutional level (pharmacogenetics) is a rising trend in oncology. This review covers the latest strategies based upon the search of relevant biomarkers for efficacy, resistance and toxicity to be undertaken at the bedside to shift towards precision medicine in breast cancer patients.
  
  
  CONCLUSIONS
  In the expanding era of bioguided medicine, identifying relevant and clinically validated biomarkers from the plethora of published material remains an uneasy task. Sorting the variety of genetic and molecular markers that have been investigated over the last decade on their level of evidence and addressing the issue of drug exposure should help to improve the management of breast cancer therapy.
authors.affiliation: SMARTc Pharmacokinetics Unit, UMR S_911 CRO2, AMU , Marseille , France.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ciccolini
authors.forename: Raphaelle
authors.initials: R
authors.lastname: Fanciullino
authors.forename: Cindy
authors.initials: C
authors.lastname: Serdjebi
authors.forename: Gérard
authors.initials: G
authors.lastname: Milano
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics; D004305:Dose-Response Relationship, Drug; D015195:Drug Design; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D010597:Pharmacogenetics; D057285:Precision Medicine / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: breast cancer; pharmacogenetics; pharmacogenomics; pharmacokinetics