Molecular heterogeneity in breast cancer: State of the science and implications for patient care.

Autor: Ellsworth RE; Murtha Cancer Center, Windber, PA, USA., Blackburn HL; Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA, USA., Shriver CD; Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, USA., Soon-Shiong P; NantWorks, Culver City, CA, USA., Ellsworth DL; Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA, USA. Electronic address: d.ellsworth@wriwindber.org.
Jazyk: angličtina
Zdroj: Seminars in cell & developmental biology [Semin Cell Dev Biol] 2017 Apr; Vol. 64, pp. 65-72. Date of Electronic Publication: 2016 Aug 26.
DOI: 10.1016/j.semcdb.2016.08.025
Abstrakt: The identification of extensive genetic heterogeneity in human breast carcinomas poses a significant challenge for designing effective treatment regimens. Significant genomic evolution often occurs during breast cancer progression, creating variability within primary tumors as well as between the primary carcinoma and metastases. Current risk allocations and treatment recommendations for breast cancer patients are based largely on characteristics of the primary tumor; however, genetic differences between disseminated tumor cells and the primary carcinoma may negatively impact treatment efficacy and survival. In this review we (1) present current information about genomic variability within primary breast carcinomas, between primary tumors and regional/distant metastases, among circulating tumor cells (CTCs) and disseminated tumor cells (DTCs), and in cell-free nucleic acids in circulation, and (2) describe how this heterogeneity affects clinical care and outcomes such as recurrence and therapeutic resistance. Understanding the evolution and functional significance of the composite breast cancer genome within each patient is critical for developing effective therapies that can overcome obstacles presented by molecular heterogeneity.
(Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: