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SUMMARY:"Towards personalized medicine in Breast Cancer" - Prof. Dr. Sabin
 e C. Linn\, medical oncologist Netherlands Cancer Institute – Antoni van
  Leeuwenhoek Hospital\, Amsterdam\, the Netherlands
DTSTART:20121113T120000Z
DTEND:20121113T130000Z
UID:TALK37663@talks.cam.ac.uk
CONTACT:Mala Jayasundera
DESCRIPTION:Currently\, approximately 50% of all breast cancer patients ar
 e cured by loco regional therapy. Without adjuvant systemic therapy\, 50% 
 of patients will develop metastatic disease and ultimately die of the dise
 ase. Adjuvant chemotherapy cures around 10% of breast cancer patients\, wh
 ile adjuvant hormonal therapy cures about 15% of patients. This means that
  still roughly 25% of breast cancer patients will die of the disease\, des
 pite optimal breast cancer treatment.\n \nSince it is very difficult to id
 entify those patients that are already cured by loco regional treatment\, 
 and since under treatment is considered worse than overtreatment\, about 9
 0% of all breast cancer patients do receive some form of adjuvant systemic
  therapy. Clearly\, this means that roughly 40% of patients receive adjuva
 nt systemic therapy unnecessarily\, with all its toxicities. In order to r
 educe overtreatment\, prognostic factors are needed\, to identify those pa
 tients who should be spared unnecessary adjuvant systemic therapy. One pro
 mising prognostic test is the 70-gene prognosis signature (MammaPrint®)\,
  which will be discussed in the seminar.\n\nFor the patients who do need a
 djuvant systemic therapy in order to be cured\, it is crucial to choose th
 e right systemic therapy. The only established predictive markers that can
  guide breast cancer therapy today are the oestrogen receptor status and t
 he HER2 status. If used only in patients who would die without adjuvant sy
 stemic therapy\, the number needed to treat to save one life is two to thr
 ee. This means that of the patients who would die without adjuvant systemi
 c therapy\, still around 50% of these patients will die of the disease\, d
 espite systemic therapy. Additional predictive factors are needed to choos
 e the drug that targets the Achilles heel of the tumour cells. In this sem
 inar promising predictive factors for identifying patients who will benefi
 t from intensified carboplatin-based chemotherapy and for identifying pati
 ents who are tamoxifen-resistant will be discussed.\n\nUltimately\, the us
 e of additional prognostic and predictive factors in breast cancer diagnos
 is and treatment will reduce overtreatment and improve survival.\n\n\n*Fur
 ther reading*\n\nBeelen K\, Zwart W\, Linn SC. Can predictive biomarkers i
 n breast cancer\nguide adjuvant endocrine therapy? Nat Rev Clin Oncol\, in
  press. doi: 10.1038/nrclinonc.2012.121\n\nVollebergh MA\, Jonkers J\, Lin
 n SC. Genomic instability in breast and ovarian cancers: translation into 
 clinical predictive biomarkers. Cell Mol Life Sci\, 69:223-45\, 2012. doi:
  10.1007/s00018-011-0809-0. \n\nBueno-de-Mesquita JM\, van Harten WH\, Ret
 el VP\, et al. Use of 70-gene signature to predict prognosis of patients w
 ith node-negative breast cancer: a prospective community-based feasibility
  study (RASTER). Lancet Oncol\, 8: 1079-1087\, 2007.\n\n*Support for this 
 Seminar is provided by EISAI*\n\n
LOCATION:CRI Lecture Theatre
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