Câncer de mama e novos alvos terapêuticos: potenciais biomarcadores

Breast cancer represents a worldwide public health problem that, excluding non-melanoma skin cancers, is the most frequent malignant tumor among women, with high rates of morbidity and mortality. Several advances have been made in the field of epidemiology, biology and the development of new drugs. Biomarkers and pathways of oncogenic signaling with drug development against molecular targets have had a great impact on patient management. Although well described in the literature, the process of epigenetic acetylation / deacetylation in breast cancer, as well as the role of histone deacetylases, such as sirtuins, has not yet been elucidated. To carry out a review of the literature on biomarkers and future therapies focusing on molecular targets still without clinical applicability; the role of nuclear sirtuin SIRT1and SIRT7 expression in tumor samples and its association with clinical features in breast cancer patients was further evaluated. Search for ongoing clinical trials in the National Clinical Trials (NCI). The expression of SIRT1and SIRT7 was investigated in tumor tissue samples by RT-PCR, and the association with clinical variables of patients. Our results has been demonstrated a series of clinical trials currently, using therapeutic targets in breast cancer with potential therapeutical on signaling pathways such as PI3K/Akt /mTOR, HER2 +, JAK / STAT, MAPK, PARP, hormone receptors, CDK4 / 6 Cyclins and PDL-1 and PD1. In the epigenetic scenario, the expression of SIRT 1 was associated with greater axillary lymph node involvement and SIRT7, to the practice of alcoholism. In conclusion, several targets and signaling pathways are in use, and others in clinical trials with promising results. SIRT1 and SIRT7 may play a role in breast carcinogenesis, especially with regard to patients with greater axillary lymph node involvement and alcoholism. New studies with a larger cohort are needed to obtain data and the development of potential epigenetic control therapeutic vectors.