Gene Mutations and Liquid Biopsy in ER-Positive Breast Cancers: A Small Step Forward, a Giant Leap for Personalization of Endocrine Therapy?
Fiche publication
Date publication
octobre 2023
Journal
Cancers
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HARLE Alexandre, Pr MERLIN Jean-Louis, Dr GILSON Pauline
Tous les auteurs :
Betz M, Massard V, Gilson P, Witz A, Dardare J, Harlé A, Merlin JL
Lien Pubmed
Résumé
The predominant forms of breast cancer (BC) are hormone receptor-positive (HR+) tumors characterized by the expression of estrogen receptors (ERs) and/or progesterone receptors (PRs). Patients with HR+ tumors can benefit from endocrine therapy (ET). Three types of ET are approved for the treatment of HR+ BCs and include selective ER modulators, aromatase inhibitors, and selective ER downregulators. ET is the mainstay of adjuvant treatment in the early setting and the backbone of the first-line treatment in an advanced setting; however, the emergence of acquired resistance can lead to cancer recurrence or progression. The mechanisms of ET resistance are often related to the occurrence of mutations in the gene, which encodes the ER-alpha protein. As mutations are hardly detectable at diagnosis but are present in 30% to 40% of advanced BC (ABC) after treatment, the timeline of testing is crucial. To manage this resistance, testing has recently been recommended; in ER+ HER2- ABC and circulating cell-free DNA, so-called liquid biopsy appears to be the most convenient way to detect the emergence of mutations. Technically, several options exist, including Next Generation Sequencing and ultra-sensitive PCR-based techniques. In this context, personalization of ET through the surveillance of mutations in the plasma of HR+ BC patients throughout the disease course represents an innovative way to improve the standard of care.
Mots clés
ESR1 gene, breast cancer, endocrine therapy, liquid biopsy
Référence
Cancers (Basel). 2023 10 27;15(21):