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Molecular Diagnosis and Targeting Therapy for Breast Cancer

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Book cover Molecular Diagnosis and Targeting for Thoracic and Gastrointestinal Malignancy

Part of the book series: Current Human Cell Research and Applications ((CHCRA))

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Abstract

Breast cancer (BC) is a representative cancer for which molecular targeting therapy is most popular, because systemic therapy is selected according to tumor biological subtypes, luminal A, luminal B, HER2-enriched, and basal-like; those are decided by gene expression pattern or estrogen receptor (ER), HER2, and tumor proliferation measured by Ki67 expression in immunohistochemistry. Approximately 70–80% of BC is ER positive. Adjuvant therapy is selected according to the guideline based on the large-scale randomized control trials. Selective estrogen receptor modulators (SERM), like tamoxifen or toremifene, and gonadotropin-releasing hormone agonist (GnRH) are used in combination or alone for premenopausal metastatic BC (MBC) and in adjuvant setting. Aromatase inhibitor (AI) targeting the enzyme aromatase is recommended for postmenopausal BC in adjuvant and MBC both in pre- and postmenopausal.

A multigene assay predicts the prognosis of luminal-type BC and selects the candidates for chemotherapy (CT). Selective ER downregulator (SERD), fulvestrant, is used for MBC. Overexpression of the human epidermal growth factor 2 (HER2) worsens the prognosis of BC, but the monoclonal antibody, trastuzumab, has drastically improved the prognosis of HER2-overexpressing BC. Anti-HER2 blockade (trastuzumab/lapatinib or trastuzumab/pertuzumab) is associated with chemotherapy (CT), or Trastuzumab-Emtansine (T-DM1) can be used for trastuzumab-resistant MBC. mTOR inhibitor everolimus or cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with AI can be used for ER-positive MBC. New therapeutic approach like apoptosis induction, inhibition of anti-apoptosis, cell cycle progression, and signal transduction are now under developing.

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Authors and Affiliations

  1. Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan

    Akira Tangoku, Takahiro Yoshida, Hirokazu Takechi, Masakazu Okumua, Misako Nakagawa, Masami Morimoto, Takeshi Nishino, Seiya Inoue, Toru Sawada, Mariko Aoyama, Naoki Miyamoto, Kohei Nishioka, Keisuke Fujimoto & Hiroaki Toba

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    Yutaka Shimada

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Tangoku, A. et al. (2018). Molecular Diagnosis and Targeting Therapy for Breast Cancer. In: Shimada, Y., Yanaga, K. (eds) Molecular Diagnosis and Targeting for Thoracic and Gastrointestinal Malignancy. Current Human Cell Research and Applications. Springer, Singapore. https://doi.org/10.1007/978-981-10-6469-2_2

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