Background: Breast cancer is distinguished in three different subtypes, based on clinical and molecular parameters: Luminal - HER2 - Basal type. Luminal carcinomas (which represent about 65% of the total) are distinguished by a particular heterogeneity of biological behaviour with disease recovery in about 40-50% and death in about two-thirds of these patients at 5 years from diagnosis, despite initial anatomopathological pictures of apparent low aggressiveness. Precisely, more biomolecular parameters are desirable for this diagnostic category which starting from an estimated disease recovery can guide therapeutic choices in a more articulated way that is modelled on the actual needs.
Method: The aim of this work is to build a panel of genes that can be used to personalize therapy and consequently reduce mortality. Our kit is patented and includes 33 genes that best characterize neoplastic heterogeneity and sensitivity to drugs. The study involved the total transcriptome (RNA) sequencing of 40 patient samples carried out in the two-year period 1994/1995 with the aim of identifying a group of genes expressed differentially among patients with good prognosis and those with poor prognosis.
Results: Total RNA extraction from formalin-fixed, paraffin-embedded samples and then Library preparation for RNA-Seq was achieved. The study highlighted some genes: CXCL13 life gene, IFITM10 death gene always present regardless of molecular subtype, and DSCAM-AS1 gene, specific for Luminal A subtype, that if present, let the patient avoid standard PBI and neoadjuvant therapy.
Conclusion: The goal is to implement a different surgical and adjuvant personalized therapy for every single patient.
