Document Detail

Biomarkers for the clinical management of breast cancer: international perspective.
MedLine Citation:
PMID:  23280579     Owner:  NLM     Status:  MEDLINE    
The higher incidence of breast cancer in developed countries has been tempered by reductions in mortality, largely attributable to mammographic screening programmes and advances in adjuvant therapy. Optimal systemic management requires consideration of clinical, pathological and biological parameters. Oestrogen receptor alpha (ERα), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) are established biomarkers evaluated at diagnosis, which identify cardinal subtypes of breast cancer. Their prognostic and predictive utility effectively guides systemic treatment with endocrine, anti-HER2 and chemotherapy. Hence, accurate and reliable determination remains of paramount importance. However, the goals of personalized medicine and targeted therapies demand further information regarding residual risk and potential benefit of additional treatments in specific circumstances. The need for biomarkers which are fit for purpose, and the demands placed upon them, is therefore expected to increase. Technological advances, in particular high-throughput global gene expression profiling, have generated multi-gene signatures providing further prognostic and predictive information. The rational integration of routinely evaluated clinico-pathological parameters with key indicators of biological activity, such as proliferation markers, also provides a ready opportunity to improve the information available to guide systemic therapy decisions. The additional value of such information and its proper place in patient management is currently under evaluation in prospective clinical trials. Expanding the utility of biomarkers to lower resource settings requires an emphasis on cost effectiveness, quality assurance and possible international variations in tumor biology; the potential for improved clinical outcomes should be justified against logistical and economic considerations.
Neill Patani; Lesley-Ann Martin; Mitch Dowsett
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2013-02-08
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  133     ISSN:  1097-0215     ISO Abbreviation:  Int. J. Cancer     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-04-22     Completed Date:  2013-06-11     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-13     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 UICC.
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MeSH Terms
Antigens, Tumor-Associated, Carbohydrate / blood
Antineoplastic Agents / pharmacology,  therapeutic use
Breast Neoplasms / blood,  drug therapy*,  epidemiology,  metabolism*
Carcinoembryonic Antigen / blood
Cell Proliferation
Cost-Benefit Analysis
Cyclin D1 / metabolism
Cyclin E / metabolism
DNA, Neoplasm
Developed Countries / statistics & numerical data
Developing Countries / statistics & numerical data
Estrogen Receptor alpha / metabolism
Estrogen Receptor beta / metabolism
Gene Expression Profiling
Health Resources / supply & distribution*
Individualized Medicine
Ki-67 Antigen / metabolism
Molecular Targeted Therapy*
Neoplastic Cells, Circulating
Plasminogen Activator Inhibitor 1 / metabolism
Predictive Value of Tests
Quality Assurance, Health Care
Receptor, erbB-2 / metabolism
Receptors, Progesterone / metabolism
Tissue Polypeptide Antigen / blood
Tumor Markers, Biological / blood,  metabolism*
Urokinase-Type Plasminogen Activator / metabolism
World Health
Grant Support
G1100450//Medical Research Council; //Medical Research Council
Reg. No./Substance:
0/Antigens, Tumor-Associated, Carbohydrate; 0/Antineoplastic Agents; 0/CCND1 protein, human; 0/Carcinoembryonic Antigen; 0/Cyclin E; 0/DNA, Neoplasm; 0/Estrogen Receptor alpha; 0/Estrogen Receptor beta; 0/Ki-67 Antigen; 0/Plasminogen Activator Inhibitor 1; 0/Receptors, Progesterone; 0/SERPINE1 protein, human; 0/Tissue Polypeptide Antigen; 0/Tumor Markers, Biological; 0/estrogen receptor alpha, human; 0/mucinous carcinoma-associated antigen; 136601-57-5/Cyclin D1; EC protein, human; EC, erbB-2; EC Plasminogen Activator

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