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Molecular Progression of Breast Cancer and Personalized Medicine in Terms of Clinical Trials

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Breast Cancer: From Bench to Personalized Medicine

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Abstract

Breast cancer (BC) is well-known for its diversified clinical behaviors despite the similar histopathological characteristics at diagnosis. Research studies on molecular pathogenesis of BC reveal that it is a multitude of various diseases having variable molecular basis that regulate therapeutic responses, long-term survival, and disease-free intervals. Remarkable similarities between the molecular progression of BC and normal development suggest that BC might be caused by mammary cancer stem cells. Various signaling pathways such as the HER2, ER, and PR regulate mammary stem cells and normal breast development by controlling stem cell motility, differentiation, proliferation, and cell death. Recent studies suggest that non-coding RNAs and epigenetic regulations might play an important part in the metastasis and heterogeneity of BC specifically for triple-negative BC (TNBC). Traditionally used therapeutic strategies depend upon the expression levels of PR, ER, and HER2. Even though the methods used for clinical classification help choose targeted therapies, the prediction of patient responses and their long-term survival remains difficult. Recent advances in the field of molecular biology (multigene assays, next-generation sequencing) have led to innovations in BC diagnostics and therapeutics. Numerous multigene assays like Oncotype DX, MammaPrint, etc. have been developed for better prediction and prognosis at the early stages of BC. The concept of personalized medicine is gaining attention due to its potential role in developing effective BC treatment regimens. The recent identification of various molecular biomarkers via gene expression profiling might help in the prediction of drug response and intensity of cancer-related symptoms. The molecular biomarkers can also help in determining optimal drug choice/drug dosage and to identify more molecular targets leading towards the development of more personalized treatment strategies. For the practical implementation of personalized BC therapies, proper evaluation and analysis of molecular specifications of BC in each patient is needed. Moreover, the epigenetic and genetic changes should also be considered in management of BC patients. Finally, clinical trials are the link between chains of knowledge and determine the role of therapeutic advances. Out of the various clinical trial designs being used, adaptive clinical trials are most frequently used as they aim at reducing the resources, lessen the completion time, and improve the possibility of detecting the effects of treatments.

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Authors and Affiliations

  1. Department of Zoology, University of Gujrat, Gujrat, Pakistan

    Somia Liaqat, Mubashar Hussain, Kiran Aftab & Maryam Khalid

  2. Department of Genetics, Research Division, The University of Alabama at Birmingham, Birmingham, AL, USA

    Saima Shakil Malik

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  1. Department of Genetics, Research Division, The University of Alabama, Birmingham, AL, USA

    Saima Shakil Malik

  2. Department of Biotechnology, Fatima Jinnah Women University, Rawalpindi, Pakistan

    Nosheen Masood

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Liaqat, S., Hussain, M., Aftab, K., Khalid, M., Shakil Malik, S. (2022). Molecular Progression of Breast Cancer and Personalized Medicine in Terms of Clinical Trials. In: Shakil Malik, S., Masood, N. (eds) Breast Cancer: From Bench to Personalized Medicine. Springer, Singapore. https://doi.org/10.1007/978-981-19-0197-3_15

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