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ESMO Breast 2021 | Future role of genomic tools in breast cancer treatment

John Bartlett, BSc, PhD, FRCPath, Ontario Institute for Cancer Research, Ontario, Canada, comments on the challenges of incorporating novel genomic tools into clinical practice for breast cancer treatment. Dr Bartlett discusses how intergration of different omics approaches is key to optimizing the management and treatment of different subgroups of patients. This interview took place at the virtual European Society for Medical Oncology (ESMO) Breast Cancer Congress 2021.

Transcript (edited for clarity)

The challenge that we face these days is our understanding of breast cancer has really exploded since we were able to really generate deep genomic and transcriptomic data on breast cancer. We now recognize the potential for maybe 30 or 40 different subtypes of breast cancer.

And so, we’re moving with these prognostic and predictive molecular tests to really try and identify specific agents which can work for some specific subgroups of cancers...

The challenge that we face these days is our understanding of breast cancer has really exploded since we were able to really generate deep genomic and transcriptomic data on breast cancer. We now recognize the potential for maybe 30 or 40 different subtypes of breast cancer.

And so, we’re moving with these prognostic and predictive molecular tests to really try and identify specific agents which can work for some specific subgroups of cancers. What we’re seeing in our work, alongside that which we presented at ESMO, was that integrating different parts of the omics universe if you want to call it that, the transcriptomics, the genomics, even proteomics and metanomics, can give you clues as to how to treat breast cancer. And the challenge going ahead is for us to take those signatures, those driver pathways which we’re identifying and really challenge them with novel drugs and make sure we do map the best treatment for individual subgroups of patients to the best outcomes and the best drugs.

This is something that’s worked very well in lung cancer and we’re seeing emerging data in prostate and other cancers, and it’s time I think for us in the breast cancer community to grasp that challenge. To look at focused smaller trials in molecularly defined subgroups and take treatment to the next level for our patients.

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Disclosures

John Bartlett, BSc, PhD, FRCPath, has participated in a consultancy role for Insight Genetics, Inc., BioNTech AG, Biotheranostics, Inc., Pfizer, Rna Diagnostics Inc., oncoXchange/MedcomXchange Communications Inc., Herbert Smith French Solicitors and OncoCyte Corporation; has participated in a scientific advisory board with MedcomXchange Communications Inc.; has received honoraria from NanoString Technologies, Inc., Oncology Education, Biotheranostics, Inc. and MedcomXchange Communications Inc.; has received research funding from Thermo Fisher Scientific, Genoptix, Agendia, NanoString Technologies, Inc., Stratifyer GmbH and Biotheranostics, Inc.; has receive travel and/or accommodations expenses from Biotheranostics, Inc., NanoString Technologies, Inc., and Breast Cancer Society of Canada; has a patent for histone gene module predicts anthracycline benefit, PCT/CA2016/000247; discloses invention of A Molecular Classifier for Personalized Risk Stratification for Patients with Prostate Cancer, Date: 21/08/2019; and has applied for the following patents: Jan 2017: Methods and Devices for Predicting Anthracycline Treatment Efficacy, US utility – 15/325,472; EPO – 15822898.1; Canada – not yet assigned, Jan 2017: Systems, Devices and Methods for Constructing and Using a Biomarker, US utility – 15/328,108; EPO – 15824751.0; Canada – not yet assigned, Dec 2016: 95-Gene Signature of Residual Risk Following Endocrine Treatment, PCT/CA2016/000304, Dec 2016: Immune Gene Signature Predicts Anthracycline Benefit, PCT/CA2016/000305, June 2020: Use of Molecular Classifiers to Diagnose, Treat and Prognose Prostate Cancer, US Provisional 63/040.692.

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