Is the future of personalized therapy in triple-negative breast cancer based on molecular subtype?
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Fanny Le Du1,2, Bedrich L. Eckhardt1, Bora Lim1,6, Jennifer K. Litton1,3,6, Stacy Moulder1,6, Funda Meric-Bernstam4,6, Ana M. Gonzalez-Angulo1,5,6, Naoto T. Ueno1,6
1Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
2Department of Medical Oncology, Eugène Marquis Cancer Center, Rennes, France
3Clinical Cancer Genetics Program, The University of Texas Graduate School of Biomedical Sciences, Houston, TX, USA
4Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
5Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
6The University of Texas MD Anderson Women’s Cancer Moons Shot Program, Houston, TX, USA
Naoto T. Ueno, e-mail: firstname.lastname@example.org
Keywords: triple-negative breast cancer, gene expression profiling, epithelial-mesenchymal transition, immunotherapy, targeted therapy
Received: February 17, 2015 Accepted: April 24, 2015 Published: May 07, 2015
Significant research has been conducted to better understand the extensive, heterogeneous molecular features of triple-negative breast cancer (TNBC). We reviewed published TNBC molecular classifications to identify major groupings that have potential for clinical trial development. With the ultimate aim to streamline translational medicine, we linked these categories of TNBC according to their gene-expression signatures, biological function, and clinical outcome. To this end, we define five potential clinically actionable groupings of TNBC: 1) basal-like TNBC with DNA-repair deficiency or growth factor pathways; 2) mesenchymal-like TNBC with epithelial-to-mesenchymal transition and cancer stem cell features; 3) immune-associated TNBC; 4) luminal/apocrine TNBC with androgen-receptor overexpression; and 5) HER2-enriched TNBC. For each defined subtype, we highlight the major biological pathways and discuss potential targeted therapies in TNBC that might abrogate disease progression. However, many of these potential targets need clinical validation by clinical trials. We have yet to know how we can enrich the targets by molecular classifications.
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