Assessing biomarkers for patients with breast cancer who are suited for adjuvant therapy.
Summary
This review examines established and emerging biomarkers for stratifying patients with early-stage breast cancer to optimize adjuvant systemic therapy. It highlights that while clinicopathological factors remain fundamental, decision-making is increasingly driven by precise biological markers. ER and HER2 status are crucial, and multigene assays refine recurrence risk and chemotherapy benefit in hormone receptor-positive cancers. Immune and DNA-repair biomarkers inform targeted therapies in HER2-positive and triple-negative subtypes, while mutation profiling of genes like ESR1, PIK3CA, AKT, MTOR, and PTEN guides targeted treatments. Emerging approaches, including liquid biopsy and artificial intelligence, offer dynamic insights but require prospective validation.
Analysis
This review is of paramount importance for clinical practice and translational research in breast oncology. It synthesizes the current state of knowledge on biomarkers, enabling better personalization of adjuvant treatments and avoiding overtreatment. The integration of multigene assays, mutation profiling, and immune biomarkers represents a major step towards precision medicine. Furthermore, the emphasis on prospective validation of new technologies like liquid biopsy and AI is crucial to ensure their future clinical relevance and improve long-term outcomes for patients.