Deep genomic analysis of breast cancer tumors should soon result in new therapeutic road maps, with treatment paradigms based on a pharmacopeia of cell-type and pathway-matched therapies. Individual cases of breast cancer will ultimately be classified based on a long list of acquired and inherited genetic changes, and appropriate etiology-matched treatment will be based on the identification of driving genetic events in each case, according to Matthew Ellis, MB, BChir, PhD, of Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis.
At the NCCN 19th Annual Conference, Dr. Ellis described the molecular subtypes of breast cancer currently part of the oncology vernacular and predicted how some less familiar mutations will eventually become essential to breast cancer management.
“Breast cancer is not one disease, and our molecular terminologies are beginning to have some clinical utility in this regard. For instance, we are able to define a subset [of patients] with very indolent disease, for whom minimal management is appropriate,” he said, “but what our genetic profiles do not yet fully tell us is how to treat high-risk patients. This is where our current efforts should be.”