Personalized medicine in breast cancer: pharmacogenomics approaches

Shabnam Jeibouei,1 Mohammad Esmael Akbari,2 Alireza Kalbasi,3 Amir Reza Aref,4,5 Mohammad Ajoudanian,6 Alireza Rezvani,7 Hakimeh Zali81Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; 4Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA; 5Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; 6Department of Tissue Engineering and Applied Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 7Department of Hematology, Medical Oncology and Stem Cell Transplantation, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 8Proteomics Research Centre, Department of Tissue Engineering and Applied Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranAbstract: Breast cancer is the fifth cause of cancer death among women worldwide and represents a global health concern due to the lack of effective therapeutic regimens that could be applied to all disease groups. Nowadays, strategies based on pharmacogenomics constitute novel approaches that minimize toxicity while maximizing drug efficacy; this being of high importance in the oncology setting. Besides, genetic profiling of malignant tumors can lead to the development of targeted therapies to be included in effective drug regimens. Advances in molecular diagnostics have revealed that breast cancer is a multifaceted disease, characterized by inter-tumoral and intra-tumoral heterogeneity and, unlike the past, molecular classifications based on the expression of individual biomarkers have led to devising novel therapeutic strategies that improve patient survival. In this review, we report and discuss the molecular classification of breast cancer subtypes, the heterogeneity resource, and the advantages and disadvantages of current drug regimens with consideration of pharmacogenomics in response and resistance to treatment.Keywords: breast cancer, personalized medicine, biomarker, pharmacogenomic