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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.

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metastatic breast cancer one size does not fit all

Metastatic Breast Cancer: One Size Does Not Fit All

Clifford Hudis, M.D.Chief, Breast Cancer Medicine Service

MSKCC

slide12
Apoptosis genes (n=641)

Cytoskeleton genes (n=641)

slide13
Five Kinds Of Breast Cancer?

HER-2+/ER-

Luminal B

Luminal A

Basal-like

Normal

Sorlie T et al, PNAS 2001

challenges
Molecular profiles are:

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 proven

Challenges
slide16
IHC for differentially expressed genes in ER(-) Class A

Class A

Class A

Class B

Class B

ALCAM

p<0.0001

ALCAM

p=0.023

A

B

SPDEF

SPDEF

p<0.0001

p<0.0001

A

B

AR

p<0.0001

AR

p=0.04

A

B

real world now
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 accordingly

Real World - Now
real world future
Your doctor tests your cancer AND your normal cells.

You and your doctor rationally select therapy predicted to control or cure the disease.

Real World - Future
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