Chapter category: Oncology
Overview of Resistance to Systemic Therapy in Patients with Breast Cancer
Breast Cancer Chemosensitivity
Edited by: Dihua Yu and Mien-Chie HungISBN: 978-0-387-74037-9
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Chapter authors:
Ana Maria Gonzalez-Angulo, Flavia Morales-Vasquez and Gabriel Hortobagyi
Breast cancer is the most common cancer and the second leading cause of cancer death in American women. It was the second most common cancer in the world in 2002, with more than 1 million new cases. Despite advances in early detection and the understanding of the molecular bases of breast cancer biology, about 30% of patients with early-stage breast cancer have recurrent disease. To offer more effective and less toxic treatment, selecting therapies requires considering the patient and the clinical and molecular characteristics of the tumor. Systemic treatment of breast cancer includes cytotoxic, hormonal, and immunotherapeutic agents. These medications are used in the adjuvant, neoadjuvant, and metastatic settings. In general, systemic agents are active at the beginning of therapy in 90% of primary breast cancers and 50% of metastases. However, after a variable period of time, progression occurs. At that point, resistance to therapy is not only common but expected. Herein we review general mechanisms of drug resistance, including multidrug resistance by P-glycoprotein and the multidrug resistance protein family in association with specific agents and their metabolism, emergence of refractory tumors associated with multiple resistance mechanisms, and resistance factors unique to host-tumor-drug interactions. Important anticancer agents specific to breast cancer are described.
Ana Maria Gonzalez-Angulo
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center
Flavia Morales-Vasquez
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center
Gabriel Hortobagyi
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center
Additional chapters from this book:
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Overview of Resistance to Systemic Therapy in Patients with Breast Cancer
Ana Maria Gonzalez-Angulo, Flavia Morales-Vasquez and Gabriel Hortobagyi
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