Hétérogénéité moléculaire des cancers du sein: Quelles implications pour la sélection des patientes en vue d'une chimiothérapie adjuvante?

Although the advantages of using adjuvant chemotherapy in the treatment of breast cancer are well established, the overall effect remains limited. As a result, there is a need to identify biomarkers that will make it possible to select the patients who can benefit from this treatment. Despite intense research in the area, no biomarker has yet been uncovered that can predict whether or not adjuvant chemotherapy can benefit a patient. One possible explanation for this may be that « breast cancer » in fact covers many diseases. In this article, we will discuss the limitations of the current research approach based on a single biomarker for the entire population within the context of intertumoural heterogeneity. We then propose three solutions to improve current results in this area: focussing on a limited number of biomarkers in a single homogenous subclass, evaluating multimarker tests, and using functional means to predict the efficiency of a given drug.