J Breast Cancer.  2012 Sep;15(3):265-272. 10.4048/jbc.2012.15.3.265.

Personalized Medicine in Breast Cancer: A Systematic Review

• Cho SH
• Jeon J
• Kim SI

• KMID: 2286451
• DOI: http://doi.org/10.4048/jbc.2012.15.3.265

Abstract

The recent advent of "-omics" technologies have heralded a new era of personalized medicine. Personalized medicine is referred to as the ability to segment heterogeneous subsets of patients whose response to a therapeutic intervention within each subset is homogeneous. This new paradigm in healthcare is beginning to affect both research and clinical practice. The key to success in personalized medicine is to uncover molecular biomarkers that drive individual variability in clinical outcomes or drug responses. In this review, we begin with an overview of personalized medicine in breast cancer and illustrate the most encountered statistical approaches in the recent literature tailored for uncovering gene signatures.

Keyword

Biomarker discovery; Breast neoplasms; Individualized medicine; Predictive biomarker; Prognostic biomarker

MeSH Terms

Biomarkers
Breast
Breast Neoplasms
Delivery of Health Care
Humans
Precision Medicine

Figure

• 

  Figure 1 Inefficacy of the one-dose-fits-all approach. This figure depicts the percentage of patients for whom a major drug is effective on average. With the high variability across diseases, 38% to 75% of patients fail to respond to a treatment. The average response rate of a cancer drug is the lowest at 25%, suggesting that 75% of patients with cancer are over-dosed and will potentially suffer from an adverse drug reaction. From Spear BB, et al. Trends Mol Med 2001;7:201-4 [1].

• 

  Figure 2 Schematic plot for a systematic statistical approach to identify predictive biomarkers.

• 

  Figure 3 Cost of sequencing a human-sized genome. Note that a logarithmic scale is used on the Y axis. The cost of sequencing rapidly decreased at an exponential rate from 2001 to 2007. The sudden drop in cost around January 2008 was due to sequencing technology geared up from the first generation ("Sanger-based" or dideoxy chain termination sequencing) to the second generation (or "next-generation"). The cost of sequencing has dramatically decreased since 2008. From Wetterstrand KA. DNA sequencing costs: data from the NHGRI large-scale genome sequencing program. http://www.genome.gov/sequencingcosts/ [81].

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