Advances in prognostic and predictive biomarkers for breast cancer: Integrating multigene assays, hormone receptors, and emerging circulating biomarkers
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引用次数: 0
Abstract
Breast cancer is a biologically diverse disease, and optimizing patient outcomes requires precise prognostic and predictive tools to guide treatment decisions. Over the past two decades, significant advances have been made in stratifying breast cancer risk through the integration of multigene assays, hormone receptor profiling, and emerging circulating biomarkers. This review outlines the current landscape and future direction of prognostic and predictive biomarker development. Combining specific multigene tests, biomarkers such as HER2/neu, and traditional clinicopathological prognostic factors is the most efficient way to determine prognosis. Well-established multigene assays such as Oncotype DX, MammaPrint, and uPA/PAI-1 are routinely employed to inform adjuvant treatment decisions in hormone receptor-positive, HER2-negative subtypes. Hormone receptor status (ER, PR) and HER2 expression continue to serve as cornerstone predictors of therapeutic response to endocrine and anti-HER2 therapies. Concurrently, a new generation of non-invasive biomarkers like circulating tumor DNA (ctDNA), microRNAs, and circulating tumor cells (CTCs) offers promise for real-time monitoring of treatment response and early detection of resistance, particularly in advanced disease. Notably, ESR1 mutations detected in ctDNA have emerged as potential indicators of resistance to aromatase inhibitors. Despite these advances, the identification of robust biomarkers to predict response to chemotherapy and radiotherapy remains a critical unmet need. This review synthesizes current evidence and highlights key challenges and opportunities in the clinical translation of biomarker-driven precision oncology for breast cancer.
期刊介绍:
The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells.
The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.