The future of breast cancer: the role of prognostic factors

Abstract

There remains a number of unmet clinical needs in patients with breast cancer that research and development aims to address. More sensitive and specific indicators of prognosis are required to identify those patients at greatest risk for disease progression. A number of biological markers including the cyclins, circulating epithelial cells, and components of the urokinase plasminogen system have been shown to correlate with patient outcome. Genomic analysis also has the potential to predict patient response to specific agents, thus ensuring patients derive the maximum benefit from the treatment they receive. Patients who require treatment are often exposed to the undesirable toxic effects that are associated with some treatments. Liposomal and nanoparticle formulations of currently available agents have been shown to be at least as effective as their parent compounds but with improved safety and tolerability profiles. Studies into patient quality of life during therapy have highlighted the importance of early administration of an erythropoietic agent to treat chemotherapy-induced anemia. Further research in breast cancer should further optimize the treatment patients receive ensuring that patients not only live longer but also have quality survival.

CytochromeP450 Epoxygenase Promotes Human Cancer Metastasis

“…In this regard, EET treatment or CYP2J2 overexpression in endothelial cells has been shown to induce t-PA expression and activity (7). Plasminogen activators, including t-PA and urokinase-type plasminogen activator, have been widely studied in carcinomas and a high level of plasminogen activator expression is associated with carcinoma metastasis and poor prognosis (27)(28)(29). Plasminogen activators convert plasminogen to a proteolytic enzyme called plasmin, which digests fibrin and matrix and promotes MMP maturation (29).…”

B-Crystallin is a novel oncoprotein that predicts poor clinical outcome in breast cancer

“…Although clinical indices such as tumor size and grade and axillary lymph node metastases are useful prognostic factors in breast cancer, there is an urgent need to identify molecular characteristics of breast carcinomas that more accurately predict clinical outcome and guide specific therapies for individual patients (2). Recent gene expression profiling of human breast cancer has led to the identification of several subtypes of breast cancer with different clinical outcomes: 2 estrogen receptor-positive (ER-positive) subtypes, a subtype with high expression of the erythroblastic leukemia viral oncogene homolog 2/HER-2 (ErbB2/HER-2) proto-oncogene, a normal breast-like subtype, and a basal-like subtype that expresses genes characteristic of basal epithelial cells and normal breast myoepithelial cells, such as cytokeratin 5 (CK5) and CK17, and does not express ER or ErbB2/HER-2 (3)(4)(5)(6).…”

Progression-Specific Genes Identified by Expression Profiling of Matched Ductal Carcinomas In situ and Invasive Breast Tumors, Combining Laser Capture Microdissection and Oligonucleotide Microarray Analysis

“…Untreated, one group of DCIS will relatively rapidly progress to the invasive stage, whereas another group will change very little within 5 to 20 years (3). Classical histopathology has a limited ability to accurately predict the risk of progression to invasive disease (4,5). Therefore, understanding the molecular biology of DCIS and its transition to IDC may provide insight into tumor initiation and progression with the aim of identifying biologically and clinically meaningful target genes and proteins.…”