Omics of chemoresistant and metastatic breast cancer

Abstract

Advances in research and knowledge, especially in the two last decades, have elucidated key pathways involved in the pathobiology, heterogeneous phenotype, molecular classification, risk, diagnosis, prognosis, and treatments for breast cancer. In spite of these advances, breast cancer still remains one of the major causes of death in developed countries. While advances in personalized medicine have allowed for management of the disease within a large and diverse number of clinical cases, and targeted treatment approaches that are less aggressive and more effective have been an important development, chemoresistance and metastasis are still the principal unsolved biological pitfalls of breast cancer. These areas deserve special attention from biomedical researchers. Thus, this chapter summarizes and highlights important analyses with regard to omics technologies, genomics, epigenetics, pharmacogenetics, transcriptomics, and metabolomics that integrate data and elucidate causes and putative solutions within the complex biological system that frames the recurrence status of the breast cancer patient. The most important milestones have been the discoveries of specific gene expression signatures, specific pathways, and miRNAs. In this context, some recent hypotheses about breast cancer stem cells or initiation tumor cell theories have gained a foothold. Nevertheless, greater efforts and higher-throughput investigations will be necessary to overcome many fundamental obstacles in the remission of the disease.