Assessment of PIK3CA Mutations in Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer: Clinical Validity but Not Utility
Menée à partir de 504 échantillons tumoraux prélevés sur des patientes atteintes d'un cancer primitif du sein HER2+, cette étude met en évidence un plus faible taux de réponses pathologiques complètes après traitement ciblant le récepteur HER2 chez les patientes dont la tumeur présente un gène PIK3CA muté
The use of anti– human epidermal growth factor receptor (HER2) targeted agents in addition to cytotoxic chemotherapy has had a substantial and positive impact on the survival of patients with HER2-overexpressing or -amplified breast cancer. However, treatment is not effective for every patient. Therefore, over the last decade or more there has been a quest to identify biomarkers that predict benefit, or more importantly, lack of benefit, from anti-HER2 therapies. Unfortunately, this quest has been unsuccessful, and so we continue to treat all patients with HER2-positive breast cancer with costly, inconvenient, and occasionally toxic therapies to ensure that we include the roughly one third who will benefit with improved disease-free and overall survival. Indeed, the most recent update of the American Society of Clinical Oncology/College of American Pathologists HER2 guidelines were admittedly directed toward sensitivity over specificity of the assays, given that these treatments have been so effective and are reasonably well tolerated.
Journal of Clinical Oncology , éditorial en libre accès, 2014