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Harold J. Burstein

“Personalized medicine” has rapidly evolved from connoting cutting-edge thinking about medical care based on individualized need to something of a cliché; everyone wants to focus on personalized medicine these days. At its core, the concept suggests that treatments could be tailored to the health needs of a given person, based on extensive and detailed understanding of the underlying biology of their disease, their intrinsic body function, and the dynamics of whatever intervention is planned. In oncology, the concept is most often linked to 2 particular aspects of personalization: use of gene expression arrays to define which cancer subset most closely describes the tumor, and use of the patient's gene profile to understand either why this cancer developed or how best to treat it. Breast cancer serves as a model disease for those seeking to develop personalized medicine in oncology. The use of biomarkers and gene expression profiling has yielded important insights into the heterogeneity of breast cancers. We now speak not of “breast cancer” as one monolithic tumor type, but of important, recognizable, definable subsets such as “HER2-positive” breast cancer, “triple-negative” breast cancer, or “ER-positive breast cancer.” Further personalization emerges in treatment algorithms. In particular, the ER-positive tumor types are being splintered into subgroups with different treatment needs. Tumor-based gene expression analyses, such as the OncotypeDX recurrence score, are used to gauge which patients with ER-positive breast cancer should have chemotherapy and which should not. Finally, breast cancer treatment holds the one instance of pharmacogenomic significance in all of cancer...
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Virginia G. Kaklamani and William J. Gradishar

improvement in pathologic complete response, and full approval is pending long-term efficacy data. This led to the approval of pertuzumab, a monoclonal antibody against HER2, in combination with trastuzumab in HER2-positive early-stage breast cancer. Recently

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Zeynep Eroglu, Odicie Fielder and George Somlo

, cytokeratins, and mammaglobin have been used for immunohistochemically based analysis. 4 , 5 Studies of the different breast cancer cell subtypes (luminal, basal-like, normal-like, and HER2 + ) have shown variable EpCAM expression levels, and low/lack of EpCAM

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Matthew Ellis

observations,” Dr. Ellis said. Luminal breast cancers (ER+, HER2-) are marked by a lengthy list of genes that are recurrently mutated. In contrast, triple-negative breast cancers (TNBC)—lacking expression of ER/progesterone receptor (PR), and for HER2

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Robert W. Carlson and on behalf of the NCCN Breast Cancer Panel

targeting the HER2 receptor with trastuzumab resulted in improved antitumor efficacy compared with chemotherapy alone in metastatic breast cancer overexpressing HER2. 1 This was rapidly followed by the initial reports of multigene array testing that showed

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Harold J. Burstein

present, the NCCN Guidelines for Breast Cancer enumerate no fewer than 12 adjuvant chemotherapy regimens, with another 6 for HER2-positive disease. Each of these has been studied in phase III trials and has historical data to support its use. Some of these

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Margaret Tempero

drug in the context of the disease at hand. Right now, I have a patient—a young woman with pancreatic cancer—who, surprisingly, has a somatic BRCA mutation and HER2 amplification. At first, I found it reassuring that we might have some different

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Margaret M. Kozak, Clare E. Jacobson, Rie von Eyben, Erqi L. Pollom, Melinda Telli and Kathleen C. Horst

biological characteristics in women aged <40 years compared with older women, 2 , 3 including higher likelihood of high-grade, estrogen receptor–negative tumors, and lymph node (LN)–positive disease, 4 – 6 However, due to a higher proportion of HER2

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Laura Spring, Rachel Greenup, Andrzej Niemierko, Lidia Schapira, Stephanie Haddad, Rachel Jimenez, Suzanne Coopey, Alphonse Taghian, Kevin S. Hughes, Steven J. Isakoff, Leif W. Ellisen, Barbara L. Smith, Michelle Specht, Beverly Moy and Aditya Bardia

tumor registry, death certificate data, and Social Security Death Master File. Survival end points were DFS and OS. A DFS event included any local or distant recurrence. Tumor biology was categorized as hormone receptor (HR)–positive, HER2-positive, or

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Nandan Maruti Shanbhag and Joycelyn Condace Phillip

Objective: To analyze the distribution of Breast Cancer at a Medical Centre, Antigua & Barbuda based on parishes, age, laterality, Er/Pr and Her2Neu status. This is first of a series of breast cancer analyses in Antigua & Barbuda. Introduction