1. Resistance to Neoadjuvant Treatment in Breast Cancer: Clinicopathological and Molecular Predictors
- Author
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Chica-Parrado, María Rosario, Godoy-Ortiz, Ana, Jiménez, Begoña, Ribelles, Nuria, Barragan, Isabel, Alba, Emilio, [Chica-Parrado,MR, Godoy-Ortiz,A, Jiménez,B, Ribelles,N, Barragan,I, Alba,E] Institute of Biomedical Research in Malaga (IBIMA), Regional and Virgen de la Victoria University Hospitals, Málaga, Spain. [Chica-Parrado,MR, Alba,E] Cancer Molecular Biology Group, Medical Research Center, University of Málaga (UMA), Málaga, Spain. [Godoy-Ortiz,A, Alba,E] Medical Oncology Service Intercentros, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain. [Barragan,I] Group of Pharmacoepigenetics, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden., and This research was funded by the Instituto de Salud Carlos III Grant PI15/01823 (to Emilio Alba, María Rosario Chica-Parrado, and Begoña Jiménez), the European Commission MSCA Grant 799,818 (to Isabel Barragán.), and the Grant for Research Support of Clinical Units of the Andalusian Health System SA0263/2017 (to Isabel Barragán). The APC was funded by the Institute of Biomedical Research in Malaga Instituto de investigación Biomédica de Málaga (IBIMA).
- Subjects
Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Recurrence [Medical Subject Headings] ,Pathological complete response ,Phenomena and Processes::Genetic Phenomena::Genetic Variation::Mutation [Medical Subject Headings] ,Residual disease ,Trastuzumab ,Predictive markers ,Neoadjuvant chemotherapy ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy::Neoadjuvant Therapy [Medical Subject Headings] ,Phenomena and Processes::Genetic Phenomena::Genetic Processes::Gene Expression [Medical Subject Headings] ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Breast cancer ,Terapia neoadyuvante ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal::Antibodies, Monoclonal, Humanized [Medical Subject Headings] ,Check Tags::Female [Medical Subject Headings] ,Neoplasias de la mama ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Anthropometry::Body Weights and Measures::Tumor Burden [Medical Subject Headings] ,Diseases::Neoplasms::Neoplastic Processes::Neoplasm Metastasis::Neoplasm Micrometastasis [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings] ,Chemicals and Drugs::Biological Factors::Biological Markers::Tumor Markers, Biological::Receptor, erbB-2 [Medical Subject Headings] ,Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings] - Abstract
Neoadjuvant Chemotherapy (NAC) in Breast Cancer (BC) has proved useful for the reduction in tumor burden prior to surgery, allowing for a more extensive breast preservation and the eradication of subjacent micrometastases. However, the impact on prognosis is highly dependent on the establishment of Pathological Complete Response (pCR), in particular for Triple Negative (TN) and Hormonal Receptor negative/Human Epidermal growth factor Receptor 2 positive (HR-/HER2+) subtypes. Several pCR predictors, such as PAM50, Integrative Cluster (IntClust), mutations in PI3KCA, or the Trastuzumab Risk model (TRAR), are useful molecular tools for estimating response to treatment and are prognostic. Major evolution events during BC NAC that feature the Residual Disease (RD) are the loss of HR and HER2, which are prognostic of bad outcome, and stemness and immune depletion-related gene expression aberrations. This dynamic nature of the determinants of response to BC NAC, together with the extensive heterogeneity of BC, raises the need to discern the individual and subtype-specific determinants of resistance. Moreover, refining the current approaches for a comprehensive monitoring of tumor evolution during treatment, RD, and eventual recurrences is essential for identifying new actionable alterations and the integral best management of the disease. Yes
- Published
- 2020