Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics
Abstract Molecular heterogeneity in metastatic breast cancer presents multiple clinical challenges in accurately characterizing and treating the disease. Current diagnostic approaches offer limited ability to assess heterogeneity that exists among multiple metastatic lesions throughout the treatment...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2021-03-01
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| Series: | npj Precision Oncology |
| Online Access: | https://doi.org/10.1038/s41698-021-00165-4 |
| _version_ | 1797430198045507584 |
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| author | Allen Li Jamie M. Keck Swapnil Parmar Janice Patterson Marilyne Labrie Allison L. Creason Brett E. Johnson Molly Downey George Thomas Carol Beadling Laura M. Heiser Annette Kolodzie Alexander R. Guimaraes Christopher L. Corless Joe W. Gray Gordon B. Mills Raymond C. Bergan Zahi I. Mitri |
| author_facet | Allen Li Jamie M. Keck Swapnil Parmar Janice Patterson Marilyne Labrie Allison L. Creason Brett E. Johnson Molly Downey George Thomas Carol Beadling Laura M. Heiser Annette Kolodzie Alexander R. Guimaraes Christopher L. Corless Joe W. Gray Gordon B. Mills Raymond C. Bergan Zahi I. Mitri |
| author_sort | Allen Li |
| collection | DOAJ |
| description | Abstract Molecular heterogeneity in metastatic breast cancer presents multiple clinical challenges in accurately characterizing and treating the disease. Current diagnostic approaches offer limited ability to assess heterogeneity that exists among multiple metastatic lesions throughout the treatment course. We developed a precision oncology platform that combines serial biopsies, multi-omic analysis, longitudinal patient monitoring, and molecular tumor boards, with the goal of improving cancer management through enhanced understanding of the entire cancer ecosystem within each patient. We describe this integrative approach using comprehensive analytics generated from serial-biopsied lesions in a metastatic breast cancer patient. The serial biopsies identified remarkable heterogeneity among metastatic lesions that presented clinically as discordance in receptor status and genomic alterations with mixed treatment response. Based on our study, we highlight clinical scenarios, such as rapid progression or mixed response, that indicate consideration for repeat biopsies to evaluate intermetastatic heterogeneity (IMH), with the objective of refining targeted therapy. We present a framework for understanding the clinical significance of heterogeneity in breast cancer between metastatic lesions utilizing multi-omic analyses of serial biopsies and its implication for effective personalized treatment. |
| first_indexed | 2024-03-09T09:24:11Z |
| format | Article |
| id | doaj.art-8c98543d96874c89b755cdec2ccf84d0 |
| institution | Directory Open Access Journal |
| issn | 2397-768X |
| language | English |
| last_indexed | 2024-03-09T09:24:11Z |
| publishDate | 2021-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Precision Oncology |
| spelling | doaj.art-8c98543d96874c89b755cdec2ccf84d02023-12-02T06:46:29ZengNature Portfolionpj Precision Oncology2397-768X2021-03-015111210.1038/s41698-021-00165-4Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analyticsAllen Li0Jamie M. Keck1Swapnil Parmar2Janice Patterson3Marilyne Labrie4Allison L. Creason5Brett E. Johnson6Molly Downey7George Thomas8Carol Beadling9Laura M. Heiser10Annette Kolodzie11Alexander R. Guimaraes12Christopher L. Corless13Joe W. Gray14Gordon B. Mills15Raymond C. Bergan16Zahi I. Mitri17Knight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityDepartment of Diagnostic Radiology, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityDepartment of Biomedical Engineering, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityKnight Cancer Institute, Oregon Health and Science UniversityAbstract Molecular heterogeneity in metastatic breast cancer presents multiple clinical challenges in accurately characterizing and treating the disease. Current diagnostic approaches offer limited ability to assess heterogeneity that exists among multiple metastatic lesions throughout the treatment course. We developed a precision oncology platform that combines serial biopsies, multi-omic analysis, longitudinal patient monitoring, and molecular tumor boards, with the goal of improving cancer management through enhanced understanding of the entire cancer ecosystem within each patient. We describe this integrative approach using comprehensive analytics generated from serial-biopsied lesions in a metastatic breast cancer patient. The serial biopsies identified remarkable heterogeneity among metastatic lesions that presented clinically as discordance in receptor status and genomic alterations with mixed treatment response. Based on our study, we highlight clinical scenarios, such as rapid progression or mixed response, that indicate consideration for repeat biopsies to evaluate intermetastatic heterogeneity (IMH), with the objective of refining targeted therapy. We present a framework for understanding the clinical significance of heterogeneity in breast cancer between metastatic lesions utilizing multi-omic analyses of serial biopsies and its implication for effective personalized treatment.https://doi.org/10.1038/s41698-021-00165-4 |
| spellingShingle | Allen Li Jamie M. Keck Swapnil Parmar Janice Patterson Marilyne Labrie Allison L. Creason Brett E. Johnson Molly Downey George Thomas Carol Beadling Laura M. Heiser Annette Kolodzie Alexander R. Guimaraes Christopher L. Corless Joe W. Gray Gordon B. Mills Raymond C. Bergan Zahi I. Mitri Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics npj Precision Oncology |
| title | Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics |
| title_full | Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics |
| title_fullStr | Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics |
| title_full_unstemmed | Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics |
| title_short | Characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics |
| title_sort | characterizing advanced breast cancer heterogeneity and treatment resistance through serial biopsies and comprehensive analytics |
| url | https://doi.org/10.1038/s41698-021-00165-4 |
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