Development of precision medicine for breast cancer in 2016: problems and solutions

doi:10.3877/cma.j.issn.1674-0807.2017.02.001

Abstract

Abstract:

According to the review of breast cancer researches in 2016, precision medicine is still a hot topic, with new achievements in gene sequencing, liquid biopsy, etc. Meanwhile, the development of precision medicine is not always smooth. Some issues, including the establishment and sharing of large data,standardization of genetic testing, restrict the technological development of breast cancer diagnosis and treatment. In the future, researchers and physicians in this field should strengthen the cooperation and datasharing, establish professional standards, speed up the development of new drugs and apply the technologies of precision medicine in order to improve clinical practice.

Key words: Breast neoplasms, Oncogenes, DNA, neoplasm, Blood circulation, Precision medicine, Big data

Zefei Jiang, Fengrui Xu. Development of precision medicine for breast cancer in 2016: problems and solutions[J]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(02): 65-68.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhrxbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0807.2017.02.001

https://zhrxbzz.cma-cmc.com.cn/EN/Y2017/V11/I02/65

Figures/Tables 2

References 18

[1]	Ledford H, Tollefson J. Obama proposes cancer “moonshot” in State of the Union address[EB/OL].[2017-01-01].http:/ /www.nature.com/news/obama-proposes-cancer-moonshot-in-state-of-the-union-address-1.19155.
[2]	Prasad V. Perspective: The precision-oncology illusion[J]. Nature,2016,537(7619): S63.
[3]	Tannock IF,Hickman JA. Limits to personalized cancer medicine [J].N Engl J Med,2016,375(13):1289-1294.
[4]	Winer EP. The long and winding road: glancing back, but moving forward [EB/OL]. [2016-12-07]. https:/ /watch. ondemand. org/OnlinePlayer/files/WM01_1.PDF? ConfID=106.
[5]	Gradishar W, Salerno KE. NCCN guidelines update: breast cancer[J]. J Natl Compr Canc Netw,2016,14(5 Suppl):641-644.
[6]	Cardoso F, van't Veer LJ, Bogaerts J, et al. 70-gene signature as an aid to treatment decisions in early-stage breast cancer [J]. N Engl J Med,2016,375(8):717-729.
[7]	江泽飞, 许凤锐. 乳腺癌精准医学:热潮中的冷思考[J]. 中华外科杂志,2017,55(2):90-94.
[8]	李健斌, 江泽飞. 循环肿瘤细胞研究进展: 从计数到表型的转变[J].中华肿瘤杂志,2016,38(12):881-885.
[9]	Jiang ZF, Cristofanilli M, Shao ZM, et al. Circulating tumor cells predict progression-free and overall survival in Chinese patients with metastatic breast cancer, HER2-positive or triple-negative(CBCSG004): a multicenter, double-blind, prospective trial [J].Ann Oncol,2013,24(11):2766-2772.
[10]	Zhang S, Li L, Wang T, et al. Real-time HER2 status detected on circulating tumor cells predicts different outcomes of anti-HER2 therapy in histologically HER2-positive metastatic breast cancer patients[J].BMC Cancer,2016,16:526.
[11]	Wang T, Zhou J, Zhang S, et al. Meaningful interpretation of serum HER2 ECD levels requires clear patient clinical background, and serves several functions in the efficient management of breast cancer patients[J]. Clin Chim Acta,2016,458:23-29.
[12]	Ye Q, Qi F, Bian L, et al. Circulating-free DNA mutation associated with response of targeted therapy in human epidermal growth factor receptor 2-positive metastatic breast cancer[J]. Chin Med J (Engl),2017,130(5):522-529.
[13]	叶青, 江泽飞. 循环肿瘤DNA 检测在乳腺癌诊断中的临床应用[J].中华癌症杂志,2016,26(11):23-27.
[14]	许凤锐,江泽飞. 精准医学时代肿瘤治疗决策:大数据与小随机[J]. 中华医学杂志,2017,97(4):241-243.
[15]	Sherman RE, Anderson SA, Dal Pan GJ, et al. Real-world evidence -what is it and what can it tell us? [J]. N Engl J Med,2016,375(23):2293-2297.
[16]	Matthijs G, Souche E, Alders M, et al. Guidelines for diagnostic nextgeneration sequencing [J]. Eur J Hum Genet,2016,24(1):2-5.
[17]	Nik-Zainal S, Davies H,Staaf J,et al. Landscape of somatic mutations in 560 breast cancer whole-genome sequences[J]. Nature, 2016,534(7605):47-54.
[18]	Meric-Bernstam F, Brusco L, Shaw K, et al. Feasibility of large-scale genomic testing to facilitate enrollment onto genomically matched clinical trials[J]. J Clin Oncol,2015,33(25):2753-2762.

研究或作者	研究内容	研究方向	主要结论
CBCSG 004^[9]	CTC	计数	CTC数目是影响患者生存的独立预测因子
Zhang et al^[10]	CTC-HER-2	表型	CTC-HER-2状态可以作为PFS的预测因子之一
Wang et al^[11]	HER-2 ECD	蛋白表达	HER-2 ECD状态可作为HER-2阳性乳腺癌患者靶向治疗疗效的预测指标
Ye et al^[12]	ctDNA	基因表达	可应用ctDNA测序探索抗HER-2靶向治疗疗效相关的生物标志物

研究或作者	研究内容	研究方向	主要结论
CBCSG 004^[9]	CTC	计数	CTC数目是影响患者生存的独立预测因子
Zhang et al^[10]	CTC-HER-2	表型	CTC-HER-2状态可以作为PFS的预测因子之一
Wang et al^[11]	HER-2 ECD	蛋白表达	HER-2 ECD状态可作为HER-2阳性乳腺癌患者靶向治疗疗效的预测指标
Ye et al^[12]	ctDNA	基因表达	可应用ctDNA测序探索抗HER-2靶向治疗疗效相关的生物标志物

靶向药物	治疗阶段	药物适应证批准情况
靶向药物	治疗阶段	FDA	EMA	SFDA
曲妥珠单克隆抗体	新辅助治疗	√	√
	辅助治疗	√	√	√
	解救治疗	√	√	√
帕妥珠单克隆抗体	新辅助治疗	√		研究中
	辅助治疗			研究中
	解救治疗	√	√	研究中
T-DM1	新辅助治疗
	辅助治疗
	解救治疗	√	√	研究中
拉帕替尼	新辅助治疗
	辅助治疗
	解救治疗	√	√	√

靶向药物	治疗阶段	药物适应证批准情况
靶向药物	治疗阶段	FDA	EMA	SFDA
曲妥珠单克隆抗体	新辅助治疗	√	√
	辅助治疗	√	√	√
	解救治疗	√	√	√
帕妥珠单克隆抗体	新辅助治疗	√		研究中
	辅助治疗			研究中
	解救治疗	√	√	研究中
T-DM1	新辅助治疗
	辅助治疗
	解救治疗	√	√	研究中
拉帕替尼	新辅助治疗
	辅助治疗
	解救治疗	√	√	√

Please choose a citation manager

Content to export