Abstract
Breast cancer is a remarkably heterogeneous disease. Data clearly demonstrate the presence of multiple molecular subtypes of breast cancer, and alterations in cell physiology shared by most tumors have been identified. These recent developments in our understanding of the molecular events involved in breast cancer have led to the identification of novel targets as well as anticancer therapies based on these targets. These therapies are referred to as targeted therapy in that the agent has a high specificity for molecules involved in molecular events responsible for the cancer phenotype. This review highlights some of the most promising future targets in breast cancer.
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American Cancer Society. Breast Cancer Facts & Figures 2009–2010. Atlanta: American Cancer Society.
Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.
Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature. 2000;406:747–52.
Sorlie T, Perou AM, Tibshirani R, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001;98:10869–74.
Yu K, Lee CH, Tan PH, et al. Conservation of breast cancer molecular subtypes and transcriptional patterns of tumor progression across distinct ethnic populations. Clin Cancer Res. 2004;10:5508–17.
Weigelt B, Hu Z, He X, et al. Molecular portraits and 70-gene prognosis signature are preserved throughout the metastatic process of breast cancer. Cancer Res. 2005;65:9155–8.
Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000;100:57–70.
•• Hanahan D, Weinberg RA. Hallmarks of Cancer: the Next Generation. Cell 2011, 144: 646-74. This article provides a foundation for understanding targeted agents.
Slamon DJ, Clark GM, Wong SG, et al. Human breast cancer: correlation of relapse and survival with amplification of the HER2neu oncogene. Science. 1987;235:177–82.
• Dawood S, Broglio K, Buzdar A, et al. Prognosis of women with metastatic breast cancer by HER2 status and trastuzumab treatment: An institutional-based review. J Clin Oncol 2009, 28:92–98. This article provides an understanding of the improved prognosis with HER2-targeted agents.
Geyer CE, Forster J, Lindquist D, et al. Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med. 2006;355:2733–43.
Lewis Phillips GD, Li G, Duggar DL, et al. Targeting HER2-positive breast cancer with trastuzumab-DM1, an antibody-cytotoxic drug conjugate. Cancer Res. 2008;68:9280–90.
Burris HA, Rugo HS, Vukelja SJ, et al. Phase II study of the antibody drug conjugate, trastuzumab-DM1 for the treatment of human epidermal growth factor receptor 2(HER2)-positive breast cancer after prior HER2-directed therapy. J Clin Oncol. 2010;29:398–405.
Adams CW, Allison DE, Flagella K, et al. Humanization of a recombinant monoclonal antibody to produce a therapeutic HER dimerization inhibitor, pertuzumab. Cancer Immunol Immunother. 2006;55:717–27.
Baselga J, Gelman KA, Verma S, et al. Phase II trial of pertuzumab and trastuzumab in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer that progressed during prior trastuzumab therapy. J Clin Oncol. 2010;28:1138–44.
Rabindran SK, Discafani CM, Rosfjord EC, et al. Antitumor activity of HKI-272, an orally active, irreversible inhibitor of the HER2 tyrosine kinase. Cancer Res. 2004;64:3958–65.
Burstein HJ, Sun Y, Dirix LY, et al. Neratinib, an irreversible ErbB receptor tyrosine kinase inhibitor, in patients with advanced, ErbB2-positive breast cancer. J Clin Oncol. 1010;28:1301–7.
• Fong PC, Boss DS, Yap TA, et al. Inhibition of poly (ADP-ribose) polymerase in tumors from BRCA mutation carriers. N Engl J Med 2009, 26:882–93. This article provides an understanding of the mechanism of action of PARP inhibitors.
Turner N, Tutt A, Ashworth A. Hallmarks of “BRCAness”in sporadic cancers. Nat Rev Cancer. 2004;4:814–9.
Tutt A, Robson M, Garber JE, et al. Phase II trial of the oral PARP inhibitor olaparib in BRCA-deficient advanced breast cancer J Clin Oncol 2009; 27 (18 suppl): Abs CRA501
O’Shaughnessy J, Osborne C, Pippen JE, et al. Iniparib plus chemotherapy in metastatic triple-negative breast cancer. N Engl J Med. 2011;364:205–14.
Zhou J, Wulfkuhle J, Zhang H, et al. Activation of the PTEN/mTOR/STAT3 pathway in breast cancer stem-like cells is required for viability and maintenance. PNAS. 2007;104:16158–63.
Miller TW, Balko JM, Arteaga C. Phosphatidylinositol 3-kinase and antiestrogen resistance in breast cancer. J Clin Oncol. 2011;29:1–10.
Baselga J, et al. Eur J Cancer Suppl. 2011; 47 (suppl 2): abstract 9LBA
Mayer EL, Krop IE. Advances in targeting Src in the treatment of breast cancer and other solid malignancies. Clin Cancer Res. 2010;16:3526–32.
Gucalp A, Sparano JA, Caravelli J, et al. Phase II trial of saracatinib (AZDO530), an oral SRC-inhibitor for the treatment of patients with hormone receptor-negative metastatic breast cancer. Clin Breast Cancer 2011; May 3 (epub ahead of print).
Mayer E, Baurain J, Sparano J, et al. Dasatinib in advanced HER2/neu amplified and ER/PR-positive breast cancer: Phase II study CA 180088. J Clin Oncol 2009; 27:15s (suppl; abstr 1011).
Folkman J. What is the evidence that tumors are angiogenesis dependent? J Natl Cancer Inst. 1990;82:4–6.
Relf M, LeJeune S, Scott PA, et al. Expression of the angiogenic factors vascular endothelial cell growth factor, acidic and basic fibroblast growth factor, tumor growth factor beta-1, platelet-derived endothelial cell growth factor, placenta growth factor, and pleiotrophin in human primary breast cancer and its relation to angiogenesis. Cancer Res. 1997;57:963–9.
Miller K, Wang M, Gralow J, et al. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med. 2007;357:2666–76.
Miles DW, Chan A, Dirix LY, et al. Phase III study of bevacizumab plus docetaxel compared with placebo plus docetaxel for the first-line treatment of human epidermal growth factor receptor 2-negative metastatic breast cancer. J Clin Oncol. 2010;28:3239–47.
Robert NJ, Dieras V, Glaspy J, et al. RIBBON-1: randomized, double-blind, placebo-controlled, phase III trial of chemotherapy with or without bevacizumab for first-line treatment of human epidermal growth dactor receptor2-negative, locally recurrent or metastatic breast cancer. J Clin Oncol. 2011;29:1252–60.
O’Shaughnessy J, Miles D, Gray RJ, et al. A meta-analysis of overall survival data from 3 randomized trials of bevacizumab (BV) and first-line chemotherapy as treatment for patients with metastatic breast cancer (MBC). J Clin Oncol. 2010;28:1005.
Bergh J, Greial R, Voytko N, et al. Sunitinib (SU) in combination with docetaxel (D) vs D alone for the first-time treatment of advanced breast cancer (ABC). J Clin Oncol 2010: 28: 7s(abs LBA 1010)
Crown J, Dieras V, Staroslawska E, et al. Phase III trial of sunitinib (SU) in combination with capecitabine (C) versus C in previously treated advanced breast cancer (ABC). J Clin Oncol 2010; 28: 7s(abs LBA 1011)
Robert NJ, Saleh MN, Paul D, et al. Sunitinib plus paclitaxel versus bevacizumab plus paclitaxel for first-line treatment of patients with advanced breast cancer: a phase III, randomized, open-label trial. Clin Breast Cancer. 2011;11:273.
Gradishar WJ, Kaklamani V, Prasad Sahoo T et al. A double-blind, randomized, placebo-controlled, Phase IIb study evaluating the efficacy and safety of sorafenib (SOR) in combination with paclitaxel (PAC) as a first-line therapy in patients (pts) with locally recurrent or metastatic breast cancer (BC). Cancer Res 2009: 69 (24 suppl): Abstract 44.
Baselga J; Roche H, Costa F, et al. SOLTI-0701: A multinational double-blind, randomized Phase IIB study evaluating the efficacy and safety of sorafenib compared to placebo when administered in combination with capecitabine in patients with locally advanced or metastatic breast cancer (BC). Cancer Res 2009: 69 (24 suppl): Abstract 45.
Hudis C, Tauer KW, Hermann RC, et al. Sorafenib (SOR) plus chemotherapy (CRx) for patients (pts) with advanced (adv) breast cancer (BC) previously treated with bevacizumab (BEV). J Clin Oncol 2011; 29: (suppl) abstract 1009.
Papa V, Gliozzo B, Clark GM, et al. Insulin-like growth factor-1 receptors are overexpressed and predict a low risk in human breast cancer. Cancer Res. 1993;53:3736–40.
Zhang H, Yee D. Type 1 Insulin-like growth factor receptor as a therapeutic target in cancer. Cancer Res. 2005;12:10123–7.
Kaufman PA, Ferrero JM, Bourgeois H, et al. A randomized, double-blind, placebo-controlled, phase 2 study of AMG 479 with exemestane (E) or fulvestrant (F) in postmenopausal women with hormone-receptor positive (HR+) metastatic (M) or locally advanced (LA) breast cancer (BC). Cancer Res 2010: Abstract S1-4
Kim LS, Kim JH. Heat shock protein as molecular targets for breast cancer therapeutics. J Breast Cancer. 2011;14(3):167–74.
Modi S, Sugarman S, Stopeck A, et al. Phase II trial of the HSP90 inhibitor tanespimycin (Tan) + trastuzumab (T) in patients (pts) with HER2-positive metastatic breast cancer (MBC). J Clin Oncol 2008; 26: 47s (abstract 1027).
Mehnert JM, Kelly WK. Histone deacetylase inhibitors: biology and mechanism of action. Cancer J. 2007;13:23–9.
Luu TH, Morgan RJ, Leong L, et al. A phase II trial of vorinostat (suberoylanilide hydroxamic acid) in metastatic breast cancer: a California cancer consortium study. Clin Cancer Res. 2008;14:7138–42.
Munster PN, Thurn KT, Thomas S, et al. A phase II study of the histone deacetylase inhibitor vorinostat combined with tamoxifen for the treatment of patients with hormone therapy-resistant breast cancer. Br J Cancer. 2011;104:1828–35.
Disclosure
M. Cianfrocca has received honoraria for her work on the Advisory Boards of Genentech and Celgene and has had travel expenses covered by these companies as well.
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Cianfrocca, M. What Are the Most Important New Targets in Breast Cancer?. Curr Breast Cancer Rep 4, 83–88 (2012). https://doi.org/10.1007/s12609-011-0068-y
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DOI: https://doi.org/10.1007/s12609-011-0068-y