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Journal ArticleDOI

Challenges translating breast cancer gene signatures into the clinic

TLDR
The hurdles in the development and validation of molecular classification systems, and prognostic and predictive signatures based on microarray gene-expression profiling are discussed and it is suggested that similar challenges are likely to be encountered in translating next-generation sequencing data into clinically useful information.
Abstract
The advent of microarray-based gene-expression profiling a decade ago raised high expectations for rapid advances in breast cancer classification, prognostication and prediction. Despite the development of molecular classifications, and prognostic and predictive gene-expression signatures, microarray-based studies have not yielded definitive answers to many of the questions that remain germane for the successful implementation of personalized medicine. There are a lack of robust signatures to predict benefit from specific therapeutic agents and it is still not possible to predict prognosis or chemotherapy treatment response in specific disease subsets accurately, such as triple-negative breast cancer. We discuss the hurdles in the development and validation of molecular classification systems, and prognostic and predictive signatures based on microarray gene-expression profiling. We suggest that similar challenges are likely to be encountered in translating next-generation sequencing data into clinically useful information. Finally we highlight strategies for the development of clinically useful molecular predictors in the future.

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Citations
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Journal ArticleDOI

Cancer stem cell-driven efficacy of trastuzumab (Herceptin): towards a reclassification of clinically HER2-positive breast carcinomas.

TL;DR: Contrary to the current dichotomous model used clinically, this model proposes that a reclassification of cHER2+ tumors based on the spectrum of molecular BC subtypes might inform on their CSC-determined sensitivity to trastuzumab, thus providing a better delineation of the predictive value of c HER2+ in BC by incorporating CSCs-driven intra-tumor heterogeneity into clinical decisions.
Journal ArticleDOI

Prognostic Value of Ki-67 in Patients With Resected Triple-Negative Breast Cancer: A Meta-Analysis.

TL;DR: A high Ki-67 expression is a poor prognostic factor of resected TNBC, and the cut-off of ki-67 ≥40% is associated with a greater risk of recurrence and death compared with lower expression rates, despite the Ki- 67 threshold with the greatest prognostic significance is as yet unknown.
Journal ArticleDOI

New Advances in Molecular Breast Cancer Pathology.

TL;DR: An update on the molecular classification of BC and molecular prognostic assays is provided and Companion diagnostics, contribution of massive parallel sequencing and the use of liquid biopsy are highlighted.
Journal ArticleDOI

Individualized therapy for metastatic colorectal cancer.

TL;DR: This review focuses on the latest progress made within the genomic and proteomic fields, concerning predictive biomarkers for individualized therapy in metastatic CRC.
Journal ArticleDOI

Gene expression profiling to dissect the complexity of cancer biology: Pitfalls and promise

TL;DR: It is concluded that while high throughput technologies developed to determine gene expression profiles potentially offer an effective tool for dissecting the biology of cancer pathologies, there are limitations to their use in understanding cancer biology and in routine clinical application.
References
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Journal ArticleDOI

Molecular portraits of human breast tumours

TL;DR: Variation in gene expression patterns in a set of 65 surgical specimens of human breast tumours from 42 different individuals were characterized using complementary DNA microarrays representing 8,102 human genes, providing a distinctive molecular portrait of each tumour.
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Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications

TL;DR: Survival analyses on a subcohort of patients with locally advanced breast cancer uniformly treated in a prospective study showed significantly different outcomes for the patients belonging to the various groups, including a poor prognosis for the basal-like subtype and a significant difference in outcome for the two estrogen receptor-positive groups.
Journal ArticleDOI

Gene expression profiling predicts clinical outcome of breast cancer

TL;DR: DNA microarray analysis on primary breast tumours of 117 young patients is used and supervised classification is applied to identify a gene expression signature strongly predictive of a short interval to distant metastases (‘poor prognosis’ signature) in patients without tumour cells in local lymph nodes at diagnosis, providing a strategy to select patients who would benefit from adjuvant therapy.
Journal ArticleDOI

Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials

O. Abe, +412 more
- 14 May 2005 - 
TL;DR: The 10-year and 15-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival are reported and it is found that the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis.
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