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Disclosure/Disclaimer

Disclosure/Disclaimer. The Molecular Basis of Breast Cancer slide presentation is not an independent educational program, and no CME credits will be provided. This program is not intended to promote any cancer agent or class approved by the FDA/EMA or currently under clinical development.

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  1. Disclosure/Disclaimer • The Molecular Basis of Breast Cancer slide presentation is not an independent educational program, and no CME credits will be provided. This program is not intended to promote any cancer agent or class approved by the FDA/EMA or currently under clinical development. • The contents of this slide presentation are owned solely by Genentech; any unauthorized uses are prohibited. • This program is presented on behalf of Genentech and the information presented is consistent with FDA guidelines. • The following slides are selected samples from a complete presentation. They are for educational purposes only. BIO0002078200 1

  2. Sex hormone biology and its role in breast carcinoma PREMENOPAUSAL Granulosa Ovaries AROMATASE ESTRADIOL Periphery Corpus luteum ESTRONE AROMATASE POSTMENOPAUSAL Breast adipose tissue Adrenal glands ANDROSTENEDIONE Breast (peripheral) Fabian CJ. Int J ClinPract. 2007;61:2051-2063. 2

  3. HER2 expression and prognosis in breast cancer HER2 protein expression measured by IHC • Shortened median survival in patients with HER2 overexpression (combined adjuvant and metastatic): • HER2+ 2 to 3 years • HER2 normal 6 to 7 years IHC 0 IHC 1+ IHC 2+ IHC 3+ HER=human epidermal growth factor receptor; IHC=immunohistochemistry. Andrulis IL, et al. J Clin Oncol. 1998;16:1340-1349.Ellis CM, et al. J Clin Pathol. 2005;58:710-714.Banerjee R, et al. J PharmacolExpTher. 2010;334:9-20. Images courtesy of Genentech. 3

  4. BRCA1 and BRCA2 have important roles in DNA repair Notes DNA damage Germline mutations in BRCA1 and BRCA2 genes predispose women to an increased risk of breast and ovarian cancers. References: Venkitaraman AR. Functions of BRCA1 and BRCA2 in the biological response to DNA damage. J Cell Sci. 2001;114:3591-3598. BRCA1 Mutations in BRCA1or BRCA2 BRCA2 RAD51 Failed repair of checkpoint genes Cell-cycle progression despite damage Accumulation of mutations Cancer BRCA=breast cancer. Venkitaraman AR. J Cell Sci. 2001; 114:3591-3598. 4

  5. Akt Ras Sos Grb2 Shc PI3K PDK1 Raf PTEN GSK3b NFκB mTOR MEK BAD Cyclin D1 MAPK p27 The HER2 signaling pathway and anti-HER2monoclonal antibodies Notes HER3 HER2 HER3 Domain IV A strategy to stem proliferative signaling in cancer cells is to target the extracellular region of growth receptors with monoclonal antibodies. Reference: Adjei AA, Hidalgo M. Intracellular signal transduction pathway proteins as targets for cancer therapy. J ClinOncol. 2005;23:5386-­5403. ↓Apoptosis ↑Survival Cell-cyclecontrol Angiogenesis Proliferation HER=human epidermal growth factor receptor; Ras=rat sarcoma; Sos=son of sevenless; Grb2=growth factor receptor-bound 2; PI3K=phosphatidylinositol 3-kinase; PDK=phosphoinositide-dependent kinase; PTEN=phosphatase and tensin homolog; Raf=rapidly accelerating fibrosarcoma; MEK=mitogen-activated protein kinase kinase; MAPK=mitogen-activated protein kinase; mTOR=mammalian target of rapamycin; BAD=Bcl-2–associated death promoter; NFκB=nuclear factor kappa–light-chain-enhancer of activated B-cells; GSK=glycogen synthase kinase. Adjei AA, Hidalgo M. J ClinOncol. 2005;23:5386-5403. 5

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