HER2-Positive Breast Cancer Lacks Validated Predictive Biomarkers Beyond HER2 Itself
Despite numerous translational research efforts, no biomarker beyond HER2 has achieved clinical utility for predicting response to anti-HER2 therapies in breast cancer. The authors call for a fundamental shift away from small single-centre biomarker studies toward large, well-annotated multi-centre databases. Immune-based biomarkers and molecular imaging for tumour heterogeneity quantification represent the most promising emerging approaches.
The original study
HER2-positive breast cancer is lost in translation: time for patient-centered research.
- Authors
- Gingras I, Gebhart G, de Azambuja E, Piccart-Gebhart M
- Journal
- Nature reviews. Clinical oncology
- Type
- Journal Article, Review
- PMID
- 28762384
Original abstract
No biomarker beyond HER2 itself, which suffers from a low positive predictive value, has demonstrated clinical utility in breast cancer, despite numerous attempts to improve treatment tailoring for the growing number of anti-HER2 targeted therapies. This prompted us to examine the body of evidence, using a systematic approach, to identify putative predictive biomarkers in HER2-positive breast cancer, and discuss the hitherto failure to address the needs of patients. In the future, it is hoped immune-based biomarkers will predict benefit from anti-HER2 treatments in the neoadjuvant and adjuvant settings. In advanced-stage disease, the quantification of tumour heterogeneity using molecular-imaging technology has generated informative data on the success or failure of the antibody-drug conjugate T-DM1. Treatment tailoring remains a high priority, in cost-constrained health-care systems, but such tailoring will require a dramatic shift in the way translational research is being conducted, with the establishment of large, easily accessible, and well-annotated databases of candidate predictive biomarkers. Single-centre biomarker research should become a thing of the past.