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The promise of liquid biopsy in cancer:a clinical perspective

Chinese Journal of Cancer Research 2015年第5期27卷 488-490页

作者： Enrico Cortesi michela palleschi Valentina Magri Giuseppe Naso Medical Oncology Unit Department of Radiological Oncological and Pathological SciencesSapienzaUniversity of Rome

The clinical utility of liquid biopsy in cancer treatment will increase as circulating tumor cells （CTCs） analysis move from the enumeration to the real-time measurement of tumor characteristics. Intratumor heterogeneity is becoming increasingly recognized as a major drawback to the shift to personalized medicine. Spatial and temporal heterogeneity might be reflected by the serial assessment of CTCs. Indeed, the developing technologies for CTCs analysis now allow digital genomic and next- generation sequencing approaches, able to differentiate molecular subtypes of the disease and to monitor genetic variation over time. The liquid biopsy of cancer might offer a real-time assessment of tumor biology, providing the opportunity to serially evaluate patients most likely to benefit from targeted drugs based on a dynamic characterization of the disease at the molecular level. Mthough hurdles remain before liquid biopsy is seen in routine clinical practice, the information derived from CTCs may facilitate the real-time identification of actionable mutations in cancer leading the way toward personalized medicine.

关键词： Circulating tumor cells （CTCs） breast liquid biopsy cancer

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Can cyclin-dependent kinase 4/6 inhibitors convert inoperable breast cancer relapse to operability? A case report

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World Journal of Clinical Cases 2020年第3期8卷 517-521页

作者： michela palleschi Roberta Maltoni Eleonora Barzotti Elisabetta Melegari Annalisa Curcio Lorenzo Cecconetto Samanta Sarti Silvia Manunta Andrea Rocca Department of Medical Oncology Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori(IRST)IRCCSMeldola 47014Italy Breast Surgery Unit Ospedale Morgagni-PierantoniForlì47121Italy

BACKGROUND Pathological complete response(pCR) is rare in hormone receptor-positive(HR+)HER2-negative breast cancer(BC) treated with either endocrine therapy(ET) or chemotherapy. Radical resection of locoregional relapse, although potentially curative in some cases, is challenging when the tumor invades critical structures.The oral cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with ET has obtained a significant increase in objective response rates and progression-free survival in patients with advanced BC and is now being evaluated in the neoadjuvant setting. We present a clinical case of a patient with an inoperable locoregional relapse of HR+ HER2-negative BC who experienced p CR after treatment with palbociclib.CASE SUMMARY We report the clinical case of a 60-year-old patient who presented with an inoperable locoregional relapse of HR+, HER2-negative BC 10 years after the diagnosis of the primary tumor. During a routine follow-up visit, breast magnetic resonance imaging and positron emission tomography/computed tomography revealed a 4-cm lesion in the right subclavicular region, infiltrating the chest wall and extending to the subclavian vessels, but without bone or visceral involvement. Treatment was begun with palbociclib plus letrozole, converting the disease to operability over a period of 6 mo. Surgery was performed and a p CR achieved. Of note, during treatment the patient experienced a very uncommon toxicity characterized by burning tongue and glossodynia associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. A reduction in the dose of palbociclib did not provide relief and treatment with the inhibitor was thus discontinued, resolving the tongue symptoms. Laboratory exams were unremarkable. Given that this was a late relapse, the tumor was classified asendocrine-sensitive, a condition associated with high sensitivity to palbociclib.CONCLUSION This case highlights the potential of the cyclin-dependent kinase 4/6 inhibitor plus ET combination to achieve pCR in locoregional

关键词： Hormone receptor-positive advanced breast cancer Endocrine therapy Cyclin-dependent kinase 4/6 inhibitor Pathological complete response

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