There’s no standard medical definition for precision medicine (also called personalized medicine). So, you may hear this term used in different ways.
In general, precision medicine describes tailoring (or adapting) the treatment of a disease (such as breast cancer) to give the most effective treatment for each person’s disease.
To do this, it uses information that can include:
The goal of precision medicine is to give the most effective treatment for each person’s breast cancer. This involves:
Some factors that help personalize treatment plans are related to an individual. For example, some treatments are chosen based on whether or not a woman has entered menopause.
Most factors that help personalize treatment however, are related to the breast cancer itself.
Breast cancers differ in many ways, especially at the molecular (cell) level. Factors related to the tumor give information on prognosis and help personalize treatment to give the most benefit to each person.
Although treatment is becoming more personalized, we cannot predict how any one person will respond to a certain treatment.
Treatment is personalized based on the groups a person belongs to (such as people with HER2-positive breast cancers, people with lymph node-positive breast cancers, women who are premenopausal and other groups) rather than to a specific person.
The results of clinical trials show us which therapies are most effective in which groups of people. If a certain therapy is effective in a group you belong to, then your treatment plan can be personalized to include that therapy.
For example, clinical trials have shown the HER2-targeted therapy trastuzumab (Herceptin) lowers the risk of recurrence of HER2-positive breast cancers. If your tumor is HER2-positive, your treatment plan is usually personalized to include trastuzumab.
Learn more about factors that affect treatment and prognosis.
Information related to your breast cancer helps personalize your treatment plan.
When breast cancer is diagnosed, a pathologist studies some of the tumor tissue under a microscope and runs some tests on the tissue.
The pathologist’s findings describe features of the tumor such as size, type and grade, as well as other factors that help plan your treatment.
For example, all tumors are tested for:
Tumor profiling tests (using gene expression profiling tools) give information about the genes in cancer cells. Sometimes the genetic profile of a tumor can help guide treatment. This may also be called genomic testing or molecular profiling.
Tumor profiling tests can be used to help make treatment decisions in some people with estrogen receptor-positive cancers. The tests recommended by the American Society of Clinical Oncology (ASCO) are [65-66]:
Other tools are mostly limited to the research setting. Researchers are working to address the limits of these tools.
Learn more about tumor profiling.
Learn more about factors that affect prognosis and treatment.
New drugs designed to target specific breast cancers are under study. As with most new drugs, these therapies are first studied in the treatment of metastatic breast cancer.
Findings from these studies determine whether new drugs will become part of the standard of care for metastatic breast cancer. If so, they may go on to be studied for the treatment of early breast cancer.
Researchers continue to study ways to personalize therapies to best treat each person and each breast cancer.
Targeted therapy drugs are designed to attack specific molecules or proteins involved in the development of cancer.
Targeted drug therapies for breast cancer include HER2-targeted therapies (such as trastuzumab and pertuzumab) and PI3 kinase inhibitors (such as alpelisib).
There are challenges with targeted drug therapy research.
For example, some drugs target certain cellular pathways involved in both cancer cell functions and normal cell functions. So, while these drugs may block cancer cell functions and cancer growth, they may also harm healthy cell functions and cause unintended side effects.
Researchers are looking for ways to have such drugs affect only cancer cells and leave healthy cells unharmed.
Molecular differences in breast tumors may help guide treatment and the development of new targeted therapies.
Most studies divide breast cancers into 4 molecular subtypes:
Although mainly used in the research setting, these subtypes may be useful in tailoring treatment and developing new therapies in the future.
Learn more about molecular subtypes of breast cancer.
Although still under study, your genes and personal characteristics (such as lifestyle factors) may help guide your breast cancer treatment.
At this time, personal genetic information is not used to make treatment decisions.
However, some personal factors help guide treatment choices. For example, for a woman whose treatment plan includes hormone therapy, whether or not she is postmenopausal guides her drug options.
After menopause, women can take tamoxifen or an aromatase inhibitor. Before menopause, women can only take tamoxifen (unless the aromatase inhibitor is combined with ovarian suppression).
As we increase our understanding of how a person’s genes affect breast cancer, we can use that knowledge to personalize treatments.
Being able to identify genes that might predict a person’s response to a specific therapy would help inform and personalize treatment decisions.
For example, PARP inhibitors may be more effective in treating metastatic breast cancers in people who have a BRCA1 or BRCA2 gene mutation compared to cancers in people without these mutations. The PARP inhibitor olaparib is FDA-approved for treating metastatic breast cancer in people with a BRCA1/2 gene mutation. People with HER2-negative metastatic breast cancer who may get chemotherapy are encouraged to get BRCA1/2 genetic testing to see if a PARP inhibitor may be used for treatment .
Lifestyle factors and other personal characteristics may also help personalize treatments in the future.
These topics are under study.
Findings from clinical trials continue to improve breast cancer treatment.
New therapies are being studied in clinical trials. Whether a new therapy or test becomes part of standard breast cancer care depends largely on clinical trial results.
People volunteer to take part in these research studies. If you have breast cancer, we encourage you to consider joining a clinical trial.
Susan G. Komen® in collaboration with BreastCancerTrials.org offers a custom matching service to help you find clinical trials that fit your needs.
Susan G. Komen® Breast Cancer Clinical Trial Information Helpline
If you or a loved one needs information or resources about clinical trials, call our Clinical Trial Information Helpline at 1-877 GO KOMEN (1-877- 465- 6636) or email firstname.lastname@example.org.
The Helpline offers breast cancer clinical trial education and support, such as:
Learn more about clinical trials.
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.
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