Re-biopsy what biomarkers to test for

[Nguyen]

Hello everyone,

My wife will have biopsy soon. Beside ER, PR, and Her2, what other bio markers that guide treatment selection should we ask the oncologist to test for?

Thank you very much,

Nguyen


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Linda's treatment history:

07/2014 - current: T-DM1
02/2014 – 06/2014: Everolimus (5mg), Exemestane, herceptin
08/2013 – 01/2014: Femara, herceptin
12/2012 – 07/2013: 4mg estradiol, herceptin
08/2012 - 12/2012: Fulvestran 500mg, exemestane, Herceptin (Stop everolimus due to mouthsores)
05/2012 - 08/2012: Everolimus (10mg), Exemestane, Herceptin, Zometa
08/2011 - 05/2012: Herceptin, Tykerb, Femara, Zometa
08/2010 - 08/2011: Herceptin, Femara, Zometa
09-2009 - 08/2010: Herceptin and estradiol (6mg)
09/2008 - 09/2009: Herceptin, Fulvestrant, Femara
03/2008 - 09/2008: Herceptin, Exemestane, Oophorectomy
01/2005 - 03/2008: Herceptin (readded) and Femara
07/2004: It returned again via several small nodules in the lung
10/2002: NED (via CT and CA27.29)!
10/2001 - 01/2005: Femara, (Fosamax)
12/2000 - 10/2001: Herceptin and Navelbine
12/2000: lung metastatic was diagnosed (a few small nodules)
02/1998 - 12/2000: Daily Tamoxifen
05/1997 - 04/1998: Modified Radical Mastectomy, many many cycles of chemo regiments (CAF,Taxol, Carpoplatin, Thiotepa, Navelbine, Taxotere), including HDC, and radiation
05/1997: First diagnosed with BC stage 3A, ER+, PR+, HER2 +, poorly differentiated, nuclear grade 3.

[Jackie07]

Perhaps you can get the nurse practitioner/navigator to locate a copy of the article and discuss it with your wife's doctor ...

Ann Med. (http://www.ncbi.nlm.nih.gov/pubmed/25058177#) 2014 Jul 24:1-12. [Epub ahead of print]
Epigenetic reprogramming in breast cancer: From new targets to new therapies.

Katz TA (http://www.ncbi.nlm.nih.gov/pubmed?term=Katz%20TA%5BAuthor%5D&cauthor=true&cauthor_uid=25058177)1, Huang Y (http://www.ncbi.nlm.nih.gov/pubmed?term=Huang%20Y%5BAuthor%5D&cauthor=true&cauthor_uid=25058177), Davidson NE (http://www.ncbi.nlm.nih.gov/pubmed?term=Davidson%20NE%5BAuthor%5D&cauthor=true&cauthor_uid=25058177), Jankowitz RC (http://www.ncbi.nlm.nih.gov/pubmed?term=Jankowitz%20RC%5BAuthor%5D&cauthor=true&cauthor_uid=25058177).
Author information (http://www.ncbi.nlm.nih.gov/pubmed/25058177#)


1Department of Pharmacology and Chemical Biology, University of Pittsburgh Cancer Institute, The Women's Cancer Research Center , Pittsburgh, PA , USA.


Abstract

Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among women in the United States. Recently, interest has grown in the role of epigenetics in breast cancer development and progression. Epigenetic changes such as DNA methylation, histone modifications, and abnormal expression of non-coding RNAs emerged as novel biomarkers in breast cancer diagnosis, therapy, and prevention. This review focuses on the most recent mechanistic findings underlying epigenetic changes in breast cancer development and their role as predictors of breast cancer risk. The rapid progress in our understanding of epigenetic findings in breast cancer has opened new avenues for potential therapeutic approaches via identification of epigenetic targets. We highlight the development of novel epigenetically targeted drugs, relevant clinical trials in breast cancer patients, and recent approaches combining epigenetic agents with chemotherapy and/or endocrine therapy that may incrementally improve long-term outcomes in appropriately selected breast cancer patients. Biomarkers of response are needed, however, to identify patient subsets that are most likely to benefit from epigenetic treatment strategies.

[Nguyen]

Lots of information in below articles, but nothing definitive beside ER, PR, and Her2.

http://www.medscape.com/viewarticle/516243_1

http://obroncology.com/obrgreen/article/Breast-and-Lung-Cancer-Biomarker-Research-at-ASCO-Changing-Treatment-Patterns

http://erc.endocrinology-journals.org/content/17/4/R245.full

[Jaimieh]

Thank you both. Jackie that is the odd thing was that I recurred after 5 years. I know it happens but I needed to check before I make peace with rads to the super clavicle.