Genomic Subtypes in Choosing Adjuvant Therapy for Breast Cancer

摘要

The use of gene expression profiling has impacted our understand-ing of breast cancer biology and increasingly has played a role in guiding clinicaldecisions. We have used hormone receptor (HR) and human epidermal growthfactor receptor 2 (HER2) status for years to guide selection of therapy. Morerecently, gene expression analysis has facilitated the identification of at leastfive intrinsic subtypes of breast cancer. Potential therapeutic targets have alsobeen identified using genomic profiling. Several tests, such as the 21-generecurrence score assay (Oncotype DX) and the 70-gene prognosis signature(MammaPrint), have been well validated as prognostic tools for early-stagebreast cancer, and have aided in adjuvant therapy decisions for early-stage,HR-positive breast cancer patients. Genomic profiling has the potential to pro-vide additional insight into drug discovery and clinical trial design by identify-ing appropriate targeted therapies for subtypes of breast cancer.