Molecular and Personalized Medicine in Breast Cancer


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Breast cancer research has reached the precipice of a new era in molecular and personalized medicine. Genome sequencing studies are finding cohesive data on driver mutation and possible targets for treatment. Going forward, the challenge facing researchers is translating these findings into clinically meaningful benefits for patients.

The SAFIR01 study that was recently presented at the 2012 ESMO meeting by Fabrice André, MD, PhD, and colleagues described results from the first large scale trial examining the clinical utility of whole-genome testing in breast cancer. This examination opens the door to personalizing medicine and sets the foundation for the future of molecular medicine, believes Debu Tripathy, MD.

William J. Gradishar, MD, notes that a genomic approach to selecting therapy will provide some underpinning to the decision made by physicians, in terms of cost-effectiveness and comparative advantages between agents. Linda T. Vahdat, MD, adds that genomics will be the key to future developments in not only oncology but also medicine in general.

Therapies are not currently available for many of the mutations found in the SAFIR01 trial, points out Christy A. Russell, MD. The discovery of mutations is far outpacing drug development and it will take some time before meaningful information is available on specific drugs for these mutations.

Joyce A. O’Shaughnessy, MD, adds that the complexity of cancer warrants combination strategies. The biggest news at the 2012 ASCO Annual Meeting was concerning the immunotherapy BMS-936558, which targets the PD-1 pathway, O'Shaughnessy believes. The combination of treatment strategies seems to offer the most hope for beating cancer.

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