This is an excellent summary by Dr Edith Perez in The Oncologist about the growth of individualized treatment and medicine for breast cancer (not to mention, for a lot of other diseases, too). I have written before about targeted therapies, the hope that eventually doctors will be able to understand a woman's tumor and make specific plans that will most help her. There have long been some examples of this; for breast cancer, the obvious one is tamoxifen to treat ER positive tumors. It has been around and useful for decades. More recently, there have been the AIs, and then herceptin for her2 positive tumors. There is a great deal of scientific interest and research in identifying other targets, and we are all hopeful that these discoveries will result in more effective treatment with fewer difficult side effects.
Here is the introduction and then a link:
Breast Cancer Management: Opportunities and Barriers to an Individualized Approach
EDITH A. PEREZ
A personalized approach to breast cancer management is increasinglypossible with state of the art diagnostics and treatments. However, many challenges still exist in choosing the right therapeutic strategy and the right dosing for a specific patient population. Biomarkers such as estrogen receptor, progesterone receptor, and HER-2 status are used to tailor therapy, but success rates with targeted therapy suggest that appropriate patient populations still require greater definition. The introduction of the genomic era has likewise advanced the ability to offer a tailored approach to breast cancer management, but much work is still needed in this area as well. Microarray-based gene expression profiles have demonstrated initial promise, but we need a better understanding of more complex tumor signaling pathways. Strategies include annotated tumor specimens, next-generation gene sequencing, proteomics, and metabolomics. An individualized approach to breast cancer management has the potential to offer clear clinical benefits and the ability to bring more tailored, cost-effective strategies to the market. The current issues facing the delivery of individualized breast cancer care will be the focus of this discussion.