Evaluation of targeted therapies in advanced breast cancer: the need for large-scale molecular screening and transformative clinical trial designs
作者： Z Fadoukhair , D Zardavas , M A Chad , T Goulioti , P Aftimos
DOI: 10.1038/ONC.2015.249
关键词:
摘要: Breast cancer (BC) has been classified into four intrinsic subtypes through seminal studies employing gene expression profiling analysis of primary tumours, namely the luminal A and B subtypes, human epidermal growth factor receptor 2-like subtype basal-like subtype. More recently, emergence high-throughput genomic sequencing techniques, such as next-generation or massive parallel expanded our understanding complex landscapes BC, with marked intertumour heterogeneity seen among different patients. In addition, increasing evidence indicates intratumour heterogeneity, molecular differences observed within one patient, both spatially longitudinally. These phenomena have an impact on clinical development molecularly targeted agents, classical paradigm population-based trials being no longer efficient. era genomically driven oncology, three complementary tools can accelerate agents for advanced BC follows: (i) implementation metastatic tumour lesions, exemplified by AURORA (Aiming to Understand Molecular Aberrations in Metastatic Cancer) programme; (ii) serial assessments circulating DNA, allowing a more thorough interrogation burden; (iii) new innovative trial designs able address challenges fragmentation BC.
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