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Le point sur les signatures moléculaires dans le cancer du sein

Update on molecular signatures in breast cancer

  • Synthèse / Review Article
  • Published:
Oncologie

Abstract

Routine clinical and pathological criteria cannot precisely determine the individual prognosis of breast cancer patients, leading to the “over-treatment” of many of them. Three intermediate- or high-throughput, gene-expression-based tools have been developed to make up for this lack of precision. After validation studies on independent series, they are now commercially available. Trials are in progress to assess their real clinical benefits in terms of the determination of prognosis and an enhanced-therapeutic-decision process. These first-generation molecular signatures rely mostly on estrogen receptors, HER2, and proliferation. Would a prognostic algorithm, based on a combination of a well-calibrated determination by immunohistochemistry of these markers, give as much information? This question needs to be addressed.

Résumé

Les critères usuels cliniques et pathologiques ne permettent pas de définir précisément le pronostic individuel des patientes traitées pour cancer du sein et entraînent un « surtraitement » adjuvant d’un grand nombre d’entre elles. Trois outils fondés sur l’expression génique, à moyen ou haut débit, ont été développés pour tenter de pallier cette imprécision. Leurs validations sur des séries indépendantes ont abouti à leur développement commercial. Les études sont en cours pour savoir dans quelle mesure ces signatures génomiques apportent un bénéfice cliniquement perceptible en termes de pronostic et de meilleure indication thérapeutique. Ces signatures moléculaires de première génération reposent essentiellement dans leur composition sur les voies des récepteurs aux estrogènes, du gène HER2 et de la prolifération. Il reste à démontrer qu’une utilisation de marqueurs immunohistochimiques de routine, correctement calibrés et combinés n’apporte pas une information équivalente.

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Authors and Affiliations

  1. Département de chirurgie, institut Curie, 26, rue d’Ulm, F-75005, Paris, France

    F. Reyal & R. -J. Salmon

  2. UMR 144, CNRS, institut Curie, 12, rue Lhomond, F-75005, Paris, France

    F. Reyal

  3. Département d’oncologie médicale, institut Curie, 26, rue d’Ulm, F-75005, Paris, France

    J. -Y. Pierga

  4. Université Paris-Descartes, 12, rue de l’École-de-Médecine, F-75006, Paris, France

    J. -Y. Pierga

  5. Département de biologie des tumeurs, institut Curie, 26, rue d’Ulm, F-75005, Paris, France

    A. Vincent-Salomon

  6. U830 Inserm, institut Curie, 26, rue d’Ulm, F-75005, Paris, France

    A. Vincent-Salomon

  7. Département d’oncologie radiothérapique, institut Curie, 26, rue d’Ulm, F-75005, Paris, France

    M. -A. Bollet

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  1. F. Reyal
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  2. J. -Y. Pierga
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  4. A. Vincent-Salomon
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  5. M. -A. Bollet
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Correspondence to F. Reyal.

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Reyal, F., Pierga, J.Y., Salmon, R.J. et al. Le point sur les signatures moléculaires dans le cancer du sein. Oncologie 12, 263–268 (2010). https://doi.org/10.1007/s10269-010-1876-9

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  • DOI: https://doi.org/10.1007/s10269-010-1876-9

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