Abstract
The advances in biologic analyses based on gene expression profiling have allowed the classification breast cancers into four different diseases. Also, molecular analyses have allowed the identification of a number of candidate therapeutic targets. Such identification requires, now, the evaluation of each targeted agent in biologically-selected populations. Such changes in the model of drug development induce a number of implications. First, targeted agents will have to be developed for rare molecular diseases. Second, such model of development will require the launch of bioassay for each molecular alteration. In this review, we will first present the most frequent “targetable” genomic alterations observed in breast cancers. Then, we will discuss the implications in terms of development of targeted agents.
Résumé
Les progrès des analyses biologiques ont permis de sous classer les cancers du sein en différentes entités moléculaires, et d’identifier un panel de cibles thérapeutiques candidates. L’identification de ces cibles impose, dorénavant, d’évaluer chaque médicament dans des populations définies par les analyses moléculaires. Ce changement dans le développement des médicaments pose un certain nombre de problèmes. Tout d’abord, il impose, dorénavant, de tester les médicaments dans des maladies moléculaires rares. Ensuite, il nécessite la mise au point de tests moléculaires, dont le nombre élevé pourrait à terme être un frein. Enfin, il pose le problème de l’organisation des soins autour des analyses moléculaires. Dans cette revue, nous décrirons dans un premier temps les différentes cibles thérapeutiques candidates observées dans le cancer du sein, puis nous discuterons les implications du développement de la médecine personnalisée par les analyses moléculaires.
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Tirés à part: F. André.
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Berrada, N., André, F. Traitements médicaux guidés par la biologie en pathologie mammaire. Oncologie 12, 274–277 (2010). https://doi.org/10.1007/s10269-010-1880-4
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DOI: https://doi.org/10.1007/s10269-010-1880-4