Details

Autor(en) / Beteiligte

• Gao, Jennifer J.
• Swain, Sandra M.

Titel

Luminal A Breast Cancer and Molecular Assays: A Review

Ist Teil von

• The oncologist (Dayton, Ohio), 2018-05, Vol.23 (5), p.556-565

Ort / Verlag

United States: AlphaMed Press

Erscheinungsjahr

2018

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Purpose Chemotherapy has been the historical mainstay of treatment for patients with breast cancer, with immunohistochemical markers and tumor characteristics driving treatment decisions. The discovery of different intrinsic subtypes of breast cancer has advanced the understanding of breast cancer, with gene‐based assays shedding further light on tumor behavior and response to treatment. Design This review focuses on the landscape of the luminal A subtype, its definition based on immunohistochemistry (IHC) and gene assays, the prognostic and predictive value of these assays, guideline recommendations, and treatment implications. Results Clinical studies of the prognostic value of gene‐based and IHC‐based assays in patients with luminal A‐subtype breast cancers suggest a better prognosis for these patients compared with those with breast cancers of other subtypes. Conclusion In today's era of precision medicine, the best treatment regimen for patients with luminal A‐subtype tumors is still undetermined, but available data raise the question whether chemotherapy can be omitted and endocrine therapy alone is sufficient for this patient population. Implications for Practice Immunohistochemical markers have traditionally guided treatment decisions in breast cancer. However, advances in gene‐expression profiling and availability of gene‐based assays have launched these newer tests into everyday clinical practice. Luminal A‐subtype tumors are a unique subset that may have favorable tumor biology. Properly defining this tumor subtype is important and may identify a subset of patients for whom endocrine therapy alone is sufficient. 摘要 目的.化疗一直是乳腺癌患者治疗历史中的主要疗法, 其免疫组化标志物和肿瘤特征决定了治疗决策。对不同亚型乳腺癌的探索促进了对乳腺癌的了解, 基于基因的检测方法进一步阐明了肿瘤行为和治疗反应。 设计.本综述侧重于Luminal A亚型、基于免疫组织化学（IHC）和基因检测得出的定义、这些检测的预后和预测价值、指南建议以及治疗影响等领域。 结果.基于基因和基于IHC的检测在Luminal A亚型乳腺癌患者中的预后价值的临床研究表明, 与其他亚型的乳腺癌患者相比, 这些患者的预后更好。 结论.在当今的精准医疗时代, 仍未确定Luminal A亚型肿瘤患者的最佳治疗方案, 但现有的数据可以提出的问题是, 化疗是否可以省略, 仅采用内分泌治疗是否足以满足该患者人群的需求。 对临床实践的提示：传统上, 免疫组织化学标志物指导乳腺癌治疗决策。然而, 基因表达谱的进展和基于基因的检测的可用性已将这些较新的检测投入到日常临床实践中。Luminal A亚型肿瘤是可能具有良好肿瘤生物学特征的独特亚型。正确定义这种肿瘤亚型很重要, 并且可能确定仅采用内分泌疗法即可满足其需求的患者亚组。 This review focuses on the luminal A subtype in breast cancer: how it is defined by immunohistochemical‐based and gene‐based assays, the prognostic and predictive value of these assays and treatment implications. With population studies projecting that half of all new breast cancer diagnoses will be of the luminal A subtype, the question of how to best determine whether a tumor is luminal A and how to best approach treatment is clinically important.