Overview:

This report provides a comprehensive and up-to-date review of current and recently discovered breast cancer biomarkers. Today, biomarkers recommended to guide the diagnosis and treatment of breast cancer, are limited in number. In their most recent (2007) guidelines, the American Society of Clinical Oncology (ASCO) supported the case for just nine markers, based on studies carried out between 1999 – 2006.

However, recent years have seen the discovery and clinical study of significant numbers of new biomarkers and additional clinical data are now available on earlier markers not yet in common use. Collectively, these biomarkers are providing valuable insights, diagnostically and therapeutically, in key areas of breast cancer. These include diagnosis, metastasis and spread, therapy direction, response to therapy, prognosis, predisposition, drug discovery and clinical research. This report presents the studies and a utility-based classification of more than 200 breast cancer markers, reported in studies between Jan 2003 and May 2010. Going forward, many of these will very likely find valuable application in the clinic, in diagnostics, therapeutics, clinical research and drug discovery. This report also includes (at no additional cost) a six-monthly update, allowing readers to stay current with new findings over the coming year.

Overview

Over the last decade, research has generated a wealth of biological data that characterise the changes that occur in breast cancer. These findings have advanced the understanding of this disease, and allowed the development of more discriminating diagnostic methods and treatments. Cancer embraces multiple changes at the genetic, phenotypic, cellular and histological level and nowhere are these changes more evident than in the field of cancer biomarkers, which now embraces many thousands of studies: cells, animals and human. This report presents an up-to-date review of breast cancer biomarkers, with particular focus on the research of candidate molecules in controlled clinical studies.

Biomarkers

Biomarkers identified in this report include: proteins, peptides, metabolites, genes and mutations, epigenetic species and other molecules. In particular, the report identifies molecules that offer minimally invasive techniques. As part of this report, biomarkers are classified by their potential utility. These areas include: diagnosis and staging (e.g. early detection); metastasis (e.g. to lymph nodes, bone); therapy directing (e.g. single and multiple drugs); response to therapy (e.g. favourable, resistance); prognosis (e.g. of relapse ); potential drug targets and diagnostic opportunities (e.g. novel proteins up-regulated in breast cancer tissues or elevated in the circulation); biomarker source (e.g. blood, tissue , urine); type (e.g. protein, gene); and function (e.g. of gene or protein).

Easy-to-Use

This report presents findings on more than 200 proposed breast cancer biomarkers in a review that includes studies over the last eight years, through to May 2010. The report is presented in pdf format and provides the reader with an easy-to-read layout. Biomarkers are discussed and presented by their potential utility in key breast cancer areas, including diagnosis, metastasis, response to therapy, prognosis and disease predisposition. Figures and tables from this report are also provided in pdf slide format.

Opportunities

The study of biomarkers is one of the most promising and dynamic areas of cancer research today, as scientists seek to extend their understanding of the disease at the biological level. These advances are giving rise to more discriminating diagnostic tools and therapies, as well as a providing a deeper understanding of genetic and phenotypic differences at the patient level, as medicine moves ever closer to more personalised therapies. While these developments create important opportunities, this rapidly evolving field is also seeing uncertainty as interest shifts from past findings, to more promising recent advances. This report provides a comprehensive review on current opportunities in this field. In addition, through a six-monthly is provided (at no additional cost) with this report, helping readers to remain current with new advances and opportunities. informed of future opportunities.

Six-Monthly Update

The increasing availability of advanced genomic and proteomic tools is accelerating research in the cancer biomarker field, leading to the rapid growth of new findings. To keep pace with these developments, this report includes a six-monthly update, identifying the most promising advances and opportunities. This update will automatically be sent to purchasers of this report, at no additional cost.

Number of pages: 195

Report Index

Due to the nature of this report, the majority of subheadings within chapters 2-7 are not indicated. However, three example subheadings are given for these chapters.

Executive Summary p.7

1 Breast Cancer p17

1.1 Statistics
1.2 Diagnosis
1.3 Classification
1.4 Staging
1.5 Current Biomarkers
1.6 This Report

2 Biomarkers: Diagnosis p.30

Sections 2.1 – 2.40

Example sections

2.6 Filamin-A
2.20 Alpha 2HS Glycoprotein
2.24 SPAG9

3 Biomarkers: Metastasis p.43

Sections 3.1 – 3.39

Example sections

3.5 CCR7 and CXCR4
3.8 ANX7-GTPase
3.31 Alpha CTX

4 Biomarkers : Therapy Directing p.82

Sections 4.1 – 4.26

Example sections

4.5 Hsp 90
4.12 Thymidylate phosphorylase
4.26 Bcl-2

5 Biomarkers: Response to Therapy p.101

Sections 5.1 – 5.28

Example sections

5.5 DNA Promotor Methylation
5.7 ABCB1 and GSTP1
5.24 Rho-GDIalpha RNA levels

6 Biomarkers: Prognosis p.125

Sections 6.1 - 6.42

Example sections

6.12 EGFR ECD
6.17 BCL2 or BCL2L12
6.20 Nitrotyrosine

7 Biomarkers: Predisposition p.167

Sections 7.1 – 7.39

Example sections

7.4 Bleomycin Sensitivity
7.10 ADAM 12 and MMP-9
6.4 TP53

8 Discussion p.170

9 Conclusions p. 185

Tables

Table 1.1 The classification of breast cancer types.
Table 1.2 The diagnostic staging of breast cancer.
Table 1.3 Approved or commonly used biomarkers in the diagnosis and treatment of breast cancer.
Table 2.1 Biomarkers reported to allow the detection or diagnosis of breast
cancer (name/identity, type, sensitivity (SEN), specificity (SPE), reference)
Table 2.2 Biomarkers reported to allow the detection or diagnosis of breast
cancer (name/identity, biomarker function (if known), reference)
Table 2.3 reported to allow the detection or diagnosis of breast
cancer (name, opportunity, reference)
Table 2.4 Biomarkers reported to allow the detection or diagnosis of breast cancer
(name of biomarker, development stage, biomarker source, reference)
Table 3.1 Biomarkers relating to metastatic breast cancer (name of biomarker, function, potential opportunity, reference
Table 3.2 Biomarkers relating to metastatic breast cancer (name of biomarker, type, stage, reference)
Table 3.3 Biomarkers relating to metastatic breast cancer
(name of biomarker, biomarker source, reference)
Table 4.1 Therapy-directing biomarkers in breast cancer
(name of biomarker, function, associated drug(s), reference)
Table 4.2 Therapy-directing biomarkers in breast cancer
(name of biomarker, type, development stage, biomarker source, reference)
Table 4.3 Therapy-directing biomarkers in breast cancer (name of
biomarker, potential opportunity, Response, reference)
Table 5.1 Biomarkers associated with response to therapy in breast cancer
(name of biomarker, Drug, Response, breast cancer type, reference)
Table 5.2 Biomarkers associated with response to therapy in breast cancer
(name of biomarker, biomarker type, biomarker function, source, reference)
Table 5.3 Biomarkers associated with response to therapy in breast cancer
(name of biomarker, biomarker stage, opportunity, reference)
Table 6.1 Biomarkers associated with prognosis in breast cancer (name of biomarker,
function of biomarker, better prognosis, poorer prognosis, reference)
Table 6.2 Biomarkers associated with prognosis in breast cancer (name of biomarker,
drug, cancer, outcome, reference)
Table 6.3 Biomarkers associated with prognosis in breast cancer (name of biomarker,
type, source, reference
Table 6.4 Biomarkers associated with prognosis in breast cancer (name of biomarker,
opportunity)
Table 7.1 Biomarkers associated with breast cancer predisposition or risk (name of biomarker, risk, description, reference)
Table 7.2 Biomarkers associated with breast cancer predisposition or risk (name of biomarker, type, source, reference)
Table 7.3 Biomarkers associated with breast cancer predisposition or risk (name of biomarker, potential, reference)

Figures

Figure 2.1 Chart showing the types of biomarkers (e.g. protein, gene) reported to allow the detection or diagnosis of breast cancer.
Figure 2.2 Chart showing the different sources of biomarkers (e.g. blood, tumour sample) reported to allow the detection or diagnosis of breast cancer.
Figure 2.3 Chart showing potential opportunities relating to biomarkers reported to allow the detection or diagnosis of breast cancer.
Figure 3.1 Chart showing potential opportunities relating to biomarkers associated with metastatic breast cancer.
Figure 3.2 Chart showing types of biomarker, relating to metastatic breast cancer.
Figure 3.3 Chart showing source of biomarker relating to metastatic breast cancer.
Figure 4.1 Chart showing types of biomarker, relating to therapy-directing biomarkers in breast cancer
Figure 4.2 Chart showing source of biomarker, relating to therapy-directing biomarkers in breast cancer
Figure 4.3 Chart showing potential opportunities, relating to therapy-directing biomarkers in breast cancer
Figure 4.4 Chart showing therapeutic response, relating to therapy-directing biomarkers in breast cancer
Figure 5.1 Chart showing drug type, relating to response to therapy associated biomarkers in breast cancer
Figure 5.2 Chart showing therapeutic response, relating to response to therapy associated biomarkers in breast cancer
Figure 5.3 Chart showing cancer type, relating to response to therapy associated biomarkers in breast cancer
Figure 5.4 Chart showing biomarker type, relating to response to therapy associated biomarkers in breast cancer
Figure 5.5 Chart showing biomarker source, relating to response to therapy associated biomarkers in breast cancer
Figure 5.5 Chart showing potential, relating to response to therapy associated biomarkers in breast cancer
Figure 6.1 Chart showing cancer type, relating to prognosis associated biomarkers in breast cancer
Figure 6.2 Chart showing biomarker type, relating to prognosis associated biomarkers in breast cancer
Figure 6.3 Chart showing biomarker source, relating to prognosis associated biomarkers in breast cancer
Figure 6.3 Chart showing potential opportunity, relating to prognosis associated biomarkers in breast cancer
Figure 7.1 Chart showing type of biomarker, relating to prognosis associated biomarkers in breast cancer
Figure 7.2 Chart showing source of biomarker, relating to prognosis associated biomarkers in breast cancer
Figure 7.3 Chart showing potential opportunity, relating to prognosis associated biomarkers in breast cancer