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Title: Biomarkers to individualise adjuvant systemic therapy in early breast cancer patients
Author: Moe, Maung
ISNI:       0000 0004 2742 6677
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2013
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Background Adjuvant chemotherapy, endocrine therapy, anti-HER2 therapy and radiotherapy significantly improve recurrence free and overall survivals in early breast cancers. Indications for a particular therapy have been well defined. Examples include oestrogen receptor positivity for endocrine therapy; HER2/Neu protein overexpression for anti-HER2 therapy; young age group, lymph node positivity, nuclear grade 3 and triple negativity (ie, ER/PR/HER2 negative) etc for chemotherapy; lumpectomy, > 5 cm tumour size, > 4 lymph nodes involvement etc for radiotherapy. Compared to no chemotherapy adjuvant chemotherapy can reduce the 10 years breast cancer mortality risk by one third although the absolute benefit depends on the absolute risk before the adjuvant chemotherapy as the risk reduction is proportional. The absolute risk depends on the various clinical and histopathological risk factors such as age, nuclear grade, tumour size, lymph node involvement, oestrogen hormone and HER2 receptor expressions. Various clinical guidelines, prognostic/ predictive tools and tests have been developed to calculate the absolute breast cancer specific survival risks and chemotherapy benefits to help in making the decision of “potential benefit outweighs the potential treatment toxicities” to recommend the adjuvant chemotherapy on individual basis. This principle aims to identify patients with very good prognosis for whom the toxic chemotherapy could be safely omitted and also patients with prognosis poor enough to justify offering toxic chemotherapies. However, no studies have specifically focussed on identifying patients in whom the chemotherapy could not deliver the expected benefit. Analysing molecular biomarker proteins that are functionally important in the cancer biology and chemotherapy cell killing mechanism using readily available and relatively inexpensive immunohistochemistry (IHC) method might be able to identify this Biomarkers to individualise adjuvant systemic therapy in early breast cancer Page 5 group of patients and find the targets against which novel therapy could be developed to improve their survival outcomes.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RC0254 Neoplasms. Tumors. Oncology (including Cancer)