Metastatic Breast Cancer: One Size Does Not Fit All. Clifford Hudis, M.D. Chief, Breast Cancer Medicine Service MSKCC. Breast cancer is predictable but not absolutely. Invasive Ductal Carcinoma. Message Pathways Inside Cancer Cells.
Clifford Hudis, M.D.Chief, Breast Cancer Medicine Service
HER2 Positive and HER2
HER2/neu FISH Test and HER2
Outcomes are widely variable. and HER2
Apoptosis genes (n=641) patient.
Cytoskeleton genes (n=641)
Five Kinds Of Breast Cancer? patient.
Sorlie T et al, PNAS 2001
Molecular profiles are: patient.
Variable by population studied
Poorly adapted for clinical use
Biology as yet not well characterized
Relationship to conventional chemotherapy response not well characterized
Ability to correctly identify molecular targets not yet provenChallenges
Unsupervised Cluster Analysis of 99 primary breast carcinomas from MSKCC tumor bank
IHC for differentially expressed genes in ER(-) Class A carcinomas from MSKCC tumor bank
Your doctor makes an educated guess about the pace of the disease and treats accordingly.
You and your doctor regularly assess the benefits of specific treatments and adjust accordinglyReal World - Now
Your doctor tests your cancer AND your normal cells. disease and treats accordingly.
You and your doctor rationally select therapy predicted to control or cure the disease.Real World - Future
Breast Cancer Medicine Service, MSKCC: 2005 disease and treats accordingly.