Targeting Breast Cancer: Strategies and Hope 2.0

Dear Colleagues,

Breast cancer therapeutics has evolved rapidly within the last decade as a result of the improvements in the understanding of the molecular biology of the disease. Novel drugs have significantly increased rates of disease-free survival and overall survival of the patients. In parallel, we have recognized categories of patients where de-intensification of treatment results to similar oncological outcomes while sparing patients from toxicities related to treatment. However, there is still an unmet need to improve treatments, especially for more aggressive histologies of the disease.

Regarding hormone receptor positive patients, CDK4/6 inhibitors have revolutionized treatment of metastatic as well as locally advanced disease. Unfortunately, mechanisms of primary and secondary resistance to these agents and hormonal therapy lead to disease recurrence. Further research on molecular alterations that lead to treatment failure as well as proper selection of group of patients is necessary to improve the benefits of this class of drugs. In addition, molecular data that could guide us regarding treatment sequence and possible combinatorial approaches could be of benefit.

For the Her-2 positive group of patients, antibody drug conjugates have significantly extended overall survival in patients with metastatic disease and are currently tested in the adjuvant setting as well. In addition, the efficacy of trastuzumab deruxtacan in patients with low expression of Her-2 triggers scientific research on redefining the population of patients that derive benefit from such agents. Finally, mechanisms of resistance in these drugs as well as biomarkers that could determine proper sequencing of anti-Her2 treatment are of utmost importance.

Finally, in patients with triple negative breast cancer, immunotherapy has provided novel therapeutic opportunities and increased overall survival. Despite early success, though, further understanding of the molecular biology of the disease could provide insight for combinations of immunotherapeutic and targeted agents that could further improve responses and prolong survival. It is also crucial to recognize molecular subtypes of TNBC and guide proper management with the existing agents.

All the above denote that a new, fascinating era has begun regarding the molecular research of breast cancer. The current Special Issue welcomes innovative research that could further promote our knowledge in this field and lead to the development of novel therapeutic agents. Since molecular biology and basic scientific studies are indispensable for the development of our journal, we will prioritize basic research over clinical trials/data.

Prof. Dr. Flora Zagouri
Dr. Michalis Liontos
Prof. Dr. Christos Papadimitriou
Guest Editors

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• breast cancer
• novel drugs
• hormone receptor
• inhibitor
• immunotherapy
• targeted agents