Clinical Oncology

[Gene-expression profiles in adjuvant treatment of early breast cancer]

PAJKOS Gábor

DECEMBER 10, 2018

Clinical Oncology - 2018;5(04)

[Breast cancer is a heterogeneous disease with different subtypes having a distinct biological, molecular, and clinical course. Assessments of standard clinical and pathological features have traditionally been used to determine the use of adjuvant systemic therapy in early-stage breast cancer; however, the ability to identify those who will benefi t from adjuvant chemotherapy remains a challenge, leading to over treatment of some patients. Risk stratifi cation of patients with early stage breast cancer may support adjuvant chemotherapy decision-making. This review details the development and validation of seven multi-gene classifi ers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test’s analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use.]

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[Introduction: Prostate cancer is the second most common cause of cancer world wide and is the most frequently detected cancer in the European Union in men over 50 years of age. Androgen deprivation therapy remains the corner stone of treatment for recurrent or metastatic disease. Unfortunately, nearly all patients will develop resistance to androgen blockade leading to castration-resistant prostate cancer (CRPC). Over the last 10 years, new treatment shaved ramatically improved overall survival of men with mCRPC. Current therapies are basedon AR-axis inhibitors and taxane-based chemotherapies, aswell as radiopharmaceuticals and Sipuleucel T. Areas covered: The authors provide a review of the current fi eld of systemic therapy in metastatic CRPC. This is followed by an in-depth analysis of recent developments in treatment, and the biological rationale behind these therapies. Expert opinion: Since several trials with docetaxel or novel hormonal agents showed improvement in overall survival in metastatic castration-sensitive prostate cancer, aswell as in non-metastatic castrationresistant patients, it is expected that a growing subgroup of patients will be expose dearlierto chemotherapy and to AR targeted agents. It becomes then fundamental to fi nd novel strategies to over come drug resistance and further improve survival.]

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