Antimicrobial Agents and Chemotherapy

Biography

Biography: Nina Radosevic-Robin

Abstract

Neoadjuvant chemotherapy (NACT) is proposed for the aggressive forms of breast cancer (BC), in order to reduce tumor burden and allow breast-preserving surgical treatment. After years of uniform administering the taxane/anthacycline-based regimens to all the BC patients indicated for a NACT, two major changes in BC NACT have taken place during last 10 years and have been rapidly developing: a) use of molecular methods in estimation of BC aggressiveness and b) use of agents which specifically target oncogenic driver-molecules. Those new approaches were made possible by important advances in cancer biopathology. Molecular classification of BC into luminal A, luminal B, HER2+ and triple-negative (TN) subgroup, associated to clinical parameters, provides a basis for the choice of NACT. That way luminal and TN BC are treated by “nonspecific” cytotoxics while the clinical course of HER2+ BC has been markedly improved by agents specifically targeting HER2. In order to avoid overtreatment of luminal BC, there is an increasing use of multigenic tests to predict tumor recurrence risk. On the other side, the resistance to anti-HER2 agents, observed in approximately half of the HER2+ BC, is being reduced by new targeted approaches: inhibition of several HER-family receptors or of the receptors and their downstream signal transducers. In TNBC, targeting EGFR and/or DNA damage response pathway are emerging neoadjuvant approaches. Further development of BC NACT depends on advances in prediction of response to a given treatment. In this light we will present some recent results our group has obtained in the biomarker research.