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Next-Generation Sequencing for Advanced Breast Cancer: What the Way to Go?

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Breast Cancer Research and Treatment

Part of the book series: Cancer Treatment and Research ((CTAR,volume 188))

Abstract

The rapid implementation of precision medicine tools in diagnosing and treating breast cancer (BC) has widened the potential therapeutic options for patients. The applications of gene sequencing, including next-generation gene sequencing (NGS), have led to numerous questions on how to validate, implement, interpret, prioritize and operationalize precision medicine tools to deliver meaningful and impactful interventions. Limited benefit has been portended with earlier experiences of NGS-driven treatment, in BC. However, the development and use of frameworks of clinical actionability of genomic alterations, for example, detected with NGS, has resulted in better patient selection, and potentially higher therapeutic value. The European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets (ESCAT) is a framework that includes five tiers of clinical actionability, with tier 1 reserved for approved drugs with demonstrated benefits for targetable genomic alterations. The re-analysis of clinical studies by grouping the genomic alterations and matched drugs with ESCAT, in high vs lower tiers has demonstrated a significant benefit portended by high tiers alterations, with the availability of efficacious treatments. As a result, frameworks for actionability, like ESCAT, should be fundamental in developing and implementing NGS-driven, and broadly, precision medicine research and treatments.

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Author information

Authors and Affiliations

  1. Division of New Drug Development for innovative therapies, European Institute of Oncology IRCCS, Milan, Italy

    Dario Trapani, Edoardo Crimini & Giuseppe Curigliano

  2. Department of Oncology and Hematology, University of Milan, Milan, Italy

    Edoardo Crimini & Giuseppe Curigliano

  3. Department of Oncology, Geneva University Hospitals, Geneva, Switzerland

    José Sandoval

  4. Unit of Population Epidemiology, Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland

    José Sandoval

Authors
  1. Dario Trapani
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  2. Edoardo Crimini
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  3. José Sandoval
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  4. Giuseppe Curigliano
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Corresponding author

Correspondence to Dario Trapani .

Editor information

Editors and Affiliations

  1. Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco

    Ouissam Al Jarroudi

  2. Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco

    Khalid El Bairi

  3. Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy

    Giuseppe Curigliano

Ethics declarations

GC reports: Consultancy with Bristol-Myers Squibb, Boehringer Ingelheim, Daiichi Sankyo, Foundation Medicine, GlaxoSmithKline, Lilly, Novartis, Pfizer, Roche/Genentech, Samsung, and Seagen Inc.; honoraria from Ellipses Pharma; research funding/grants from Merck; speaker’s bureau with Daiichi Sankyo, Foundation Medicine, Lilly, Novartis, Pfizer, Roche/Genentech, Samsung, and Seagen Inc.; travel from Pfizer and Roche/Genentech. The other authors report no potential COI.

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Trapani, D., Crimini, E., Sandoval, J., Curigliano, G. (2023). Next-Generation Sequencing for Advanced Breast Cancer: What the Way to Go?. In: Al Jarroudi, O., El Bairi, K., Curigliano, G. (eds) Breast Cancer Research and Treatment. Cancer Treatment and Research, vol 188. Springer, Cham. https://doi.org/10.1007/978-3-031-33602-7_13

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  • DOI: https://doi.org/10.1007/978-3-031-33602-7_13

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