How could breast cancer molecular features contribute to locoregional treatment decision making?

Détails

ID Serval
serval:BIB_B3744B53511C
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
How could breast cancer molecular features contribute to locoregional treatment decision making?
Périodique
Critical reviews in oncology/hematology
Auteur(s)
Tsoutsou P.G., Vozenin M.C., Durham A.D., Bourhis J.
ISSN
1879-0461 (Electronic)
ISSN-L
1040-8428
Statut éditorial
Publié
Date de publication
02/2017
Peer-reviewed
Oui
Volume
110
Pages
43-48
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Systemic treatments are tailored to breast cancer (BC) heterogeneity, which is not yet taken into account for radiotherapy (RT) personalization. The primary objective of this review is to summarize existing data suggesting BC subtypes and genetic assays are prognostic and predictive biomarkers useful for RT decision-making and to provide implications for their incorporation into future translational and clinical research. The evidence suggesting that BC subtypes also exhibit distinct "locoregional recurrence (LRR)" patterns is retrospective but consistent and validated in over fifteen studies. The HER-2 positive and triple negative subtypes are the most susceptible to locoregional failure. The high risk of the HER-2 positive subtype can be reversed with trastuzumab administration. Very little is known on the subtypes' intrinsic radiosensitivity properties. Genetic assays have assessed retrospectively signatures' prognostic and predictive value in patients' cohorts (several coming from prospective studies) for LRR risk and radiotherapy (RT) benefit. Further confirmation is needed before their introduction into clinical routine. Evidence on the use of molecular biomarkers for adjuvant RT tailoring is emerging but needs validation and introduction into prospective studies. The plethora of modern RT options (partial breast irradiation, hypofractionation), as well as recent evidence pointing towards more extensive radiotherapy, demand introduction of biological features into clinical trials to improve therapeutic decisions. Open questions, such as tailoring of irradiation after neo-adjuvant chemotherapy in complete responders and the understanding of the interplay between local control, systemic recurrence and survival given modern systemic treatments, need to be addressed under the prism of biology within this heterogeneous disease. Intrinsic radiobiological properties within this heterogeneity need to be highlighted in order to further improve outcomes.

Mots-clé
Breast Neoplasms/genetics, Breast Neoplasms/metabolism, Breast Neoplasms/therapy, Chemotherapy, Adjuvant, Decision Making, Female, Humans, Prognosis, Radiotherapy, Adjuvant, Risk Factors
Pubmed
Web of science
Création de la notice
30/01/2017 19:09
Dernière modification de la notice
20/08/2019 15:22
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