Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer


Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2006.0046

PERSPECTIVE
Travelling in the time: Single-gene testing, u-PA system, circulating cancer cells, multigene expression profiling and cancer stem cells may predict the future and change medical interventions in individuals
Dimitrios H. Roukos and Theodore Liakakos
ABSTRACT

Research advances in cancer diagnosis and treatment are dramatic in both hereditary and sporadic cancer.

Mutations in BRCA1 and BRCA2, mismatch-repair genes (MLH1, MSH, MSH6 and PMSH2 and CDH1 are responsible for several hereditary syndromes including breast ovarian cancer (HBOC), nonpolyposis colorectal cancer (Lynch) and diffuse gastric cancer (HDGC). CHEK2*110delC germline mutation increases by three fold the risk of breast cancer.

For the common sporadic cancer exciting research towards prediction of prognosis and response to specific therapies of individuals with cancer is based on:

  • detection of circulating cancer cells
  • the uPA system
  • single-gene genotyping for detection of specific mutations responsible for response to targeted therapy
  • gene-expression profiling of pretreatment tissue biopsies or surgical specimens
  • Cancer stem cells

Although none of these classifiers has been tested in large-scale clinical trials or incorporated into clinical practice they promise to refine risk assessments and improve therapeutic decisions in individual patients.

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Online ISSN : 1109 - 7647
   Print ISSN : 1109 - 7655

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last update: 3 February 2004