A Metabolomic Approach to Predict Breast Cancer Behavior and Chemotherapy Response

Abstract

Although the classification of breast carcinomas into molecular or immunohistochemical subtypes has contributed to a better categorization of women into different therapeutic regimens, breast cancer nevertheless still progresses or recurs in a remarkable number of patients. Identifying women who would benefit from chemotherapy could potentially increase treatment effectiveness, which has important implications for long-term survival. Metabolomic analyses of fluids and tissues from cancer patients improve our knowledge of the reprogramming of metabolic pathways involved in resistance to chemotherapy. This review evaluates how recent metabolomic approaches have contributed to understanding the relationship between breast cancer and the acquisition of resistance. We focus on the advantages and challenges of cancer treatment and the use of new strategies in clinical care, which helps us comprehend drug resistance and predict responses to treatment.

Keywords: breast cancer; drug resistance; metabolomics.

Figure 1

Chemotherapy agent could promote selective pressure of cancer stem cells (CSCs) and resistant cell clones and might increases the probability of recurrence. It may occur through pharmacological mechanisms, epigenetic modification, inhibition of DNA repair proteins, deregulation of proliferation and apoptotic pathways, metabolic alterations, autophagy increase, adenosine triphosphate (ATP)-binding cassette (ABC) efflux transporters overexpression that decreases the drug intracellular concentration. Moreover, the interactions between tumor cells and its surrounding microenvironment enriched by fibroblasts may also contribute to response to therapy.