The Role of Amino Acids in the Diagnosis, Risk Assessment, and Treatment of Breast Cancer: A Review

Round 1

Reviewer 1 Report

The review offers a detailed exploration of the involvement of amino acids in various facets of breast cancer, encompassing diagnosis, risk assessment, imaging, and treatment. It highlights the changes in individual amino acid concentrations in breast cancer compared to healthy controls and emphasizes the potential clinical implications of these findings. 

However, there is room for improvement in several areas to enhance its overall quality and scientific impact. Below are some specific suggestions for improvement:

 

Minor points: 

1. While the review discusses the changes in individual amino acids in breast cancer, it could benefit from a more detailed analysis of specific amino acids and their roles in tumorigenesis. Providing mechanistic insights into how these amino acids contribute to cancer progression would enhance the review's scientific value.
2. The accuracy of diagnostics using amino acids is mentioned to vary from 52% to 98%, but the factors contributing to this variability are not thoroughly explored. It would be helpful to discuss potential sources of variability and strategies to improve diagnostic accuracy.
3. The review touches upon the significance of amino acids in breast cancer risk assessment but lacks a comprehensive discussion of specific risk assessment models or tools that incorporate amino acid data. Providing examples or insights into such models would enhance the practical applicability of the review.
4. Although the review briefly mentions the importance of amino acids as metabolites for immune cell activation and antitumor activity, it could delve deeper into this aspect. Exploring the link between amino acid metabolism, the tumor microenvironment, and immune response would provide valuable insights.
5. The following references provide valuable insights into the role of serum metabolomic on elderly patients, thymidine kinase activity, and emerging technologies in breast cancer research. By incorporating these references, the review can provide readers with a more comprehensive understanding of the clinical applications of amino acid analysis in breast cancer.

         (1)doi.org/10.1016/j.tranon.2022.101585        

         (2)doi.org/10.1016/j.ejca.2023.03.001

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

The authors Bel'skaya et.al., of this study lay out existing evidence regarding the role of amino acids in the diagnosis, risk assessment and treatment of breast cancer. The study also summarizes data regarding amino acid concentrations in breast cancer from various studies, revealing some fluctuations in amino acid concentrations, although future in-depth studies are needed to evaluate these observations. Moreover, this review highlights the differences observed between different categories of breast cancer (e.g. TNBC). Overall, the article is well-written and easy to read. Therefore, the current work is fit for publication in its present form.

Author Response

We are very pleased that the article made a good impression on the reviewer and express our gratitude for the time spent on reviewing.