Breast Cancer From Bench To Personalized Medicine

This book provides detailed information on the etiology, pathogenesis, diagnosis, prognosis, and treatment strategies for breast cancer. The first section of the book presents epidemiology, risk factors, histopathological, immunohistochemistry, and molecular subtypes of breast cancer based on the receptor status. It also discusses the association of breast cancer with other hormone-sensitive cancers. The second section of the book covers cover BRCA1 and BRCA2-associated breast carcinogenesis, early-stage progression of breast cancer, and noninvasive biomarkers for the early detection of breast cancer. It also discusses the role of epigenetic modifications and non-coding RNAs in breast cancer metastasis and explores these as the biomarkers and therapeutic targets for breast cancer therapy. Further, it discusses the role of fibrinolytic mechanisms and circulating tumor cells in breast cancer diagnosis, prognosis, and treatment. The book also provides an update on oral poly(ADP-ribose) polymerase (PARP) inhibitors to treat breast cancer. Finally, it offers potential new options for personalized therapies for breast cancer patients, including optimizing drug dosage and identifying genetic changes associated with cancer symptom occurrence and severity.

Cancer Genomics addresses how recent technological advances in genomics are shaping how we diagnose and treat cancer. Built on the historical context of cancer genetics over the past 30 years, the book provides a snapshot of the current issues and state-of-the-art technologies used in cancer genomics. Subsequent chapters highlight how these approaches have informed our understanding of hereditary cancer syndromes and the diagnosis, treatment and outcome in a variety of adult and pediatric solid tumors and hematologic malignancies. The dramatic increase in cancer genomics research and ever-increasing availability of genomic testing are not without significant ethical issues, which are addressed in the context of the return of research results and the legal considerations underlying the commercialization of genomic discoveries. Finally, the book concludes with "Future Directions", examining the next great challenges to face the field of cancer genomics, namely the contribution of non-coding RNAs to disease pathogenesis and the interaction of the human genome with the environment. Tools such as sidebars, key concept summaries, a glossary, and acronym and abbreviation definitions make this book highly accessible to researchers from several fields associated with cancer genomics. Contributions from thought leaders provide valuable historical perspective to relate the advances in the field to current technologies and literature.

This book deals with the essential factors in the personalization of treatment for primary breast cancer. These include host issues, lymph node surgery, radiation therapy, and preoperative systemic treatment requiring specialized knowledge, multidisciplinary care experience, techniques, and research. Locoregional treatment in conjunction with systemic treatments is another important factor, with options for local therapy significantly affected by genetic BRCA mutation. Axillary treatment issues have become top priorities in recent primary breast cancer care, and these are highlighted in the book’s presentation of technological advances in lymph node mapping and diagnosis, axillary clearance in patients with nodal metastasis, and the role of axillary surgery. Attention is also given to locoregional treatment after preoperative systemic therapy. Because therapeutic impact differs depending upon biological characteristics such as tumor subtype, local therapy should be based both on tumor biology and on therapeutic response in parallel. Associated translational research and mathematical prediction tools such as nomograms also are introduced. This book provides the essence of primary breast cancer care, particularly its individualization with novel therapeutic concepts and strategies, and will greatly benefit physicians and clinical investigators in breast cancer institutions.

This book offers a comprehensive introduction to translational efforts in breast cancer, addressing the latest approaches to precision medicine based on the current state of understanding of breast cancer. With the latest developments in breast cancer research, our understanding of the genomic changes and the oncogenic signaling cascade of breast cancer has made considerable strides. Further, the immuno-environment has been demonstrated as the barrier to clinical cancer. In addition, major advances in cancer biology, immunology, genomics and metabolism have broken new ground for designing therapeutic approaches and selecting appropriate treatments on the basis of more precise information on the individual patient. As a result of these two trends, a clearer picture of the molecular landscape of breast cancers has facilitated the development of diagnostic, prognostic and predictive biomarkers for clinical oncology. All these aspects are addressed in this volume, which offers a comprehensive resource for researchers, graduate students and oncologists in cancer research.

This book describes recent advances in translational research in breast cancer and presents emerging applications of this research that promise to have meaningful impacts on diagnosis and treatment. It introduces ideas and materials derived from the clinic that have been brought to "the bench" for basic research, as well as findings that have been applied back to "the bedside". Detailed attention is devoted to breast cancer biology and cell signaling pathways and to cancer stem cell and tumor heterogeneity in breast cancer. Various patient-derived research models are discussed, and a further focus is the role of biomarkers in precision medicine for breast cancer patients. Next-generation clinical research receives detailed attention, addressing the increasingly important role of big data in breast cancer research and a wide range of other emerging developments. An entire section is also devoted to the management of women with high-risk breast cancer. Translational Research in Breast Cancer will help clinicians and scientists to optimize their collaboration in order to achieve the common goal of conquering breast cancer.

Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement of PPM is a challenge in traditional clinical, reimbursement, and regulatory landscapes because it is costly to develop and introduces a wide range of scientific, clinical, ethical, and socioeconomic issues. PPM raises a multitude of economic issues, including how information on accurate diagnosis and treatment success will be disseminated and who will bear the cost; changes to physician training to incorporate genetics, probability and statistics, and economic considerations; questions about whether the benefits of PPM will be confined to developed countries or will diffuse to emerging economies with less developed health care systems; the effects of patient heterogeneity on cost-effectiveness analysis; and opportunities for PPM’s growth beyond treatment of acute illness, such as prevention and reversal of chronic conditions. This volume explores the intersection of the scientific, clinical, and economic factors affecting the development of PPM, including its effects on the drug pipeline, on reimbursement of PPM diagnostics and treatments, and on funding of the requisite underlying research; and it examines recent empirical applications of PPM.

Nowhere is the explosion in comprehensive genomic testing more evident than in oncology. Multiple consensus guidelines now recommend molecular testing as the standard of care for most metastatic tumors. To aid in the advancement of this rapidly changing field, we intend this Special Issue of JPM to focus on technical developments in the genomic profiling of cancer, detail promising somatic alterations that either are, or have a high likelihood of being, relevant in the near future, and to address issues related to the pricing and value of these tests. The last few years have seen the cost of molecular testing decrease by orders of magnitude. In 2018, we saw the first "site-agnostic" drug approvals in cancer (for microsatellite unstable cancer (PD-1 inhibitors) and NTRK-fusions (TRK inhibitors)). Research on targetable mutations, determination of genetic "signatures" that can use multiple individual genes/pathways, development of targeted therapy, and insight into the value of new technology remains at the cutting edge of research in this field. We are soliciting papers that present new technologies to assess predictive biomarkers in cancer, original research (pre-clinical or clinical) that demonstrates promise for particular targeted therapies in cancer, and articles that explore the clinical and financial impacts of this paradigmatic shift in cancer diagnostics and treatment.

This book presents the latest advances in precision medicine in some of the most common cancer types, including hematological, lung and breast malignancies. It also discusses emerging technologies that are making a significant impact on precision medicine in cancer therapy. In addition to describing specific approaches that have already entered clinical practice, the book explores new concepts and tools that are being developed. Precision medicine aims to deliver personalized healthcare tailored to a patient’s genetics, lifestyle and environment, and cancer therapy is one of the areas in which it has flourished in recent years. Documenting the latest advances, this book is of interest to physicians and clinical fellows in the front line of the war on cancer, as well as to basic scientists working in the fields of cancer biology, drug development, biomarker discovery, and biomedical engineering. The contributing authors include translational physicians with first-hand experience in precision patient care.