摘要
肿瘤治疗战略如今主要是基于“靶向治疗模型”,它能根据每个病人的个体差异和疾病特征进行个性化治疗。正如“靶向药物”的概念,它只在肿瘤中存在“靶点”时起作用,在乳腺癌病理学中靶点可能就是雌激素受体和(或)HER2的表达。将这些生物标记物通过乳腺癌组织同伴诊断测试进行评估,然而,证据表明乳腺癌预测药理学的第一步仍然是根据形态学。例如,组织学分型(如管状、筛状癌)决定病人不需要在手术摘除前进行其它治疗。新辅助疗法研究表明化学疗法对小叶癌患者无效。预测的第二步是根据免疫表学分型,如果这四个生物标记物(雌激素、孕激素、HER2和Ki67)在免疫组织化学评价中仍是乳腺癌预测病理学中最好的试验,那么我们建立的乳腺癌诊断法已经重塑了分子药理学。这篇综述旨在讨论预测药理学现有理论来优化乳腺癌病人的管理,并着重于传统工具与分子生物学新型进展的优缺点。
关键词: 乳腺癌,诊断标记物,分子描述,个性化药物,预分析相,预测因素,靶向治疗
Current Drug Targets
Title:Predictive Diagnostic Pathology in the Target Therapy Era in Breast Cancer
Volume: 18 Issue: 1
Author(s): Caterina Marchio, Davide Balmativola, Roberta Castiglione, Laura Annaratone, Anna Sapino
Affiliation:
关键词: 乳腺癌,诊断标记物,分子描述,个性化药物,预分析相,预测因素,靶向治疗
摘要: Treatment strategies in oncology are nowadays largely based on the “target therapy model”, which allows to personalize the cure of each patient depending on distinctive host and disease features. As a general concept “targeted drugs” are effective only when the tumor exhibits the “target”, which in breast cancer pathology may correspond to the expression of estrogen receptors and/or of HER2. These biomarkers are evaluated on breast cancer tissues by companion diagnostic tests, however, evidence suggests that the first step in breast cancer predictive pathology is still represented by morphology. For instance, histological types, such as tubular and cribriform carcinomas, define patients who may not need any treatments other than surgical excision. Neoadjuvant studies have shown that patients affected by lobular carcinomas are not likely to have any beneficial effects from chemotherapy. The second step in prediction is represented by immunophenotyping. If the immunohistochemical evaluation of four markers (estrogen and progesterone receptors, HER2 and Ki67) remains the best practice for breast cancer predictive pathology, molecular pathology has certainly reshaped the way we approach breast cancer diagnosis. The aim of this review is to discuss current knowledge in predictive pathology for the management of breast cancer patients, focusing on the benefits and drawbacks of traditional tools and of novel improvements of molecular biology.
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Caterina Marchio, Davide Balmativola, Roberta Castiglione, Laura Annaratone, Anna Sapino , Predictive Diagnostic Pathology in the Target Therapy Era in Breast Cancer, Current Drug Targets 2017; 18 (1) . https://dx.doi.org/10.2174/1389450116666150203121218
DOI https://dx.doi.org/10.2174/1389450116666150203121218 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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