Breast Cancer

, Volume 19, Issue 3, pp 206–211

Eradication of breast cancer cells in patients with distant metastasis: the finishing touches?

Special Feature From improved survival to potential cure in patients with metastatic breast cancer

DOI: 10.1007/s12282-011-0266-5

Cite this article as:
Ito, Y., Iwase, T. & Hatake, K. Breast Cancer (2012) 19: 206. doi:10.1007/s12282-011-0266-5

Abstract

Cytotoxic agents are significantly active in breast cancer cells, but their usefulness has been limited in treating metastatic breast cancer (MBC). This has facilitated the development of an approach using molecular-targeted agents. Intrinsic subtypes including luminal A, luminal B, human epidermal growth factor receptor type 2 (HER2)-enriched, basal-like, and claudin-low tumors exhibit original drug responsiveness and clinical prognosis. Anti-HER2 treatments, trastuzumab or lapatinib, have demonstrated clinically significant efficacy. Poly ADP-ribose polymerase-1 inhibitors act against BRCA1-disabled breast cancer. Cancer stem cells could be the major obstacle to achieving a cure in systemic treatment. Extensive investigations are underway to develop novel agents that act on the genes or signaling of Hedgehog, Wnt, and Notch, which regulate cancer stem cells. Cancer cells undergo epithelial–mesenchymal transition (EMT) and acquire invasive properties. Breast cancer cells alter their phenotype in blood and bone marrow, e.g., circulating tumor cells or disseminated tumor cells. Cancer stem cells, like normal stem cells, may exist at niches in bone marrow. To achieve a cure for MBC, it is necessary to disrupt cancer stem cell–niche interactions or eradicate cancer stem cells. Traditional treatments with cytotoxic or endocrine agents require development in relation to intrinsic subtypes, stem cells, or EMT.

Keywords

Breast cancerCTCDTCStem cellEpithelial–mesenchymal transition

Abbreviations

ALDH

Aldehyde dehydrogenase

CTC

Circulating tumor cell

CXCR4

C-X-C motif chemokine receptor-4

DTC

Disseminated tumor cell

Dvl

Cytoplasmic disheveled

EMT

Epithelial–mesenchymal transition

ER

Estrogen receptor

HER2

Human epidermal growth factor receptor type 2

MBC

Metastatic breast cancer

PARP

Poly ADP-ribose polymerase

PCR

Polymerase chain reaction

PI3K

Phosphoinositide 3-kinase

PR

Progesterone receptor

Smo

Smoothened

RANK

Receptor activator for nuclear factor κ B

VEGF

Vascular endothelial growth factor

Copyright information

© The Japanese Breast Cancer Society 2011

Authors and Affiliations

  1. 1.Department of Medical Oncology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Department of Breast Oncology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan