Biomarcadores del cáncer de mama vs firmas genómicas: hacia la búsqueda de una terapia personalizada

Breast cancer is the most common malignancy in women and causing mortality is surpassed only by the lung cancer. Biological heterogeneity of cancer breast has implications for prognosis and therapeutic decisions. Currently, the prognoses of patients with breast cancer and treatment decisions are based on a series of clinic pathological parameters (lymph node status, histological type and grade, tumor size, status of hormone receptors and HER2 oncogene, etc.). A new breast cancer classifi cation is based on the analysis of the expression of multiple genes in each tumor. In recent years there are molecular phenotypes associated with tumor genomic profi les, upon analysis by DNA microarrays variations in patterns of genomic expression. There are basically two methods for assessing genomic profi les: a gene expression method through DNA microarrays, which requires frozen tissue and the use of RT -PCR to quantify the expression prospectively selected genes on tumor Paraffi n embedded tissues. One of the most successful example methods and best known is called Oncotype DX. This method is being used and marketed in various countries of the world due to its easy to use based on diagnostic biopsies fi xed in formalin and embedded in paraffi n; demonstrated high reproducibility and consistency as well as a great benefi t to achieve results select patients who may not require treatment with chemotherapy. In the last years, it has deepened knowledge and understanding of molecular biology of breast cancer, which has contributed to a progress in the establishment of new predictive and prognostic genomic profi les in this type of tumor, making actually the new paradigm of translational research in cancer. * Laboratorio de Investigacion Traslacional y Terapia Celular, UIMEM, CMN Siglo XXI, IMSS, Mexico, DF, Mexico. ** Departamento de Oncologia Medica, Instituto Nacional de Cancerologia, Mexico, DF, Mexico. *** Departamento de Gineco-Oncologia, Instituto Nacional de Cancerologia, Mexico, DF, Mexico. **** Servicio de Oncologia Medica, Hospital Angeles, Ciudad Juarez, Chihuahua, Mexico. ***** Servicio de Oncologia Medica, Hospital General de Mexico, Ciudad de Mexico, DF, Mexico. ****** Departamento de Patologia Molecular e Inmunopatologia, INCan, Mexico, DF, Mexico. ******* Breast Medical Oncology Department, MD Anderson Cancer Center, Houston, TX, USA. Este articulo puede ser consultado en version completa en http://www.medigraphic.com/revmexmastol www.medigraphic.org.mx