70% of patients may benefit, "Fudan classification" of luminal breast cancer tops the list of "Nature Genetics"
Fudan University Affiliated Cancer Hospital reported today that cavity-facial breast cancer is expected to be cured by “differentiation and treatment”. This is the result of a five-year scientific research effort by a team of professors Shao Zhimin and Jiang Yizhou from the Cancer Hospital, together with researchers from the School of Life Sciences of Fudan University, the Human Phenotype Research Institute, and the Shanghai Institute of Biomedical Technology. It has mapped the world's largest cavity surface Multi-omics panoramic map of breast cancer, and proposed the "Fudan cavity and surface four-point type" precise treatment strategy. The results were recently published in the top international journal "Nature Genetics" with an impact factor of 30.8.
It is reported that breast cancer has become the most common malignant tumor among women in my country, and its incidence rate is still rising rapidly. Professor Shao Zhimin, director of the General Surgery Department and Breast Surgery Department of the Cancer Hospital and director of the Fudan University Cancer Institute, summarized the context: There have been three major changes in the treatment of breast cancer. The first was radical surgery, the second was the application of systemic therapy, and the third It was at the beginning of this century that the classification and treatment of breast cancer was proposed.
Currently, breast cancer is clinically divided into luminal breast cancer, HER2-positive breast cancer, and triple-negative breast cancer based on the expression of estrogen and progesterone receptors and human epidermal growth factor 2, which respectively correspond to endocrine therapy and anti-HER2 targeting. A systemic treatment plan with treatment and chemotherapy as the main means. Such type-based treatment greatly improves the prognosis of breast cancer patients.
Earlier, Shao Zhimin's team proposed the concept of "precision treatment by classification" and spent 5 years establishing the "Fudan Quaternary Classification" of triple-negative breast cancer, the most virulent breast cancer. The relevant results were published in the top oncology journal "Tumor Cell". In one fell swoop, this strategy increased the effectiveness of diagnosis and treatment of triple-negative breast cancer to three times that of traditional chemotherapy.
For the most important cavity and facial types, endocrine therapy is one of the main methods. However, some patients who also take endocrine drugs can control the disease for a long time, while others will develop drug resistance and recurrence and metastasis at different time points, indicating that the luminal facial type is also a highly heterogeneous group. Experts sensitively believe that treatment should not simply add or subtract intensity and time, but should be more finely classified and clarify more individualized treatment plans.
Aiming at the target, a multi-party expert team jointly formed a research alliance. Through in-depth analysis of genomics, transcriptomics, metabolomics and proteomics, it is confirmed that luminal breast cancer has its own "family". There are different subtypes in the "family" with different molecular characteristics. Different treatment options The sensitivities are very different.
The team integrated the characteristics of bioinformatics big data and finally accurately divided luminal breast cancer into 4 subtypes: classic luminal type, immunomodulatory type, proliferative type and RTK-driven type.
Further research found that: the immunoregulatory subtype is rich in immune cells, suggesting that immune checkpoint inhibitors can be used for treatment; the proliferative subtype has high expression of cell cycle pathways and defects in DNA damage repair, suggesting that CDK4/6 inhibitors and PARP inhibitors can be used for treatment ; RTK-driven patients have the worst prognosis, and endocrine therapy is almost ineffective. This type is characterized by significant expression of RTK and its pathways, suggesting the need to further explore potential mechanisms, accelerate drug development, and innovate treatment options.
The team compiled real-world data on drug use and efficacy of thousands of cases of luminal breast cancer in China, prospectively collected patient-derived organoid models and conducted large-scale drug sensitivity testing, confirming the effectiveness of the "accurate classification" strategy.
Based on the above research results, for early-stage and locally advanced patients, the team designed a precise neoadjuvant treatment platform clinical study under the guidance of the "Fudan Classification" of luminal breast cancer, aiming to explore the fastest tumor shrinkage option for patients who are not suitable for surgery. patients are provided with surgical opportunities. For patients with advanced luminal breast cancer, multiple clinical trials are designed for different subtypes in order to provide patients with more appropriate and accurate choices.
Industry experts commented: This achievement is the world's first classification standard for luminal breast cancer based on a multi-dimensional big data system, laying an important foundation for the precise treatment of luminal breast cancer and the clinical practice of "one patient, one strategy".
