Mir-4728 is a Valuable Biomarker for Diagnostic and Prognostic Assessment of HER2-Positive Breast Cancer

Non-Coding RNAs Modulating Estrogen Signaling and Response to Endocrine Therapy in Breast Cancer

The largest part of human DNA is transcribed into RNA that does not code for proteins. These non-coding RNAs (ncRNAs) are key regulators of protein-coding gene expression and have been shown to play important roles in health, disease and therapy response. Today, endocrine therapy of ERα-positive breast cancer (BC) is a successful treatment approach, but resistance to this therapy is a major clinical problem. Therefore, a deeper understanding of resistance mechanisms is important to overcome this resistance. An increasing amount of evidence demonstrate that ncRNAs affect the response to endocrine therapy. Thus, ncRNAs are considered versatile biomarkers to predict or monitor therapy response. In this review article, we intend to give a summary and update on the effects of microRNAs (miRNAs), long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs) on estrogen signaling in BC cells, this pathway being the target of endocrine therapy, and their role in therapy resistance. For this purpose, we reviewed articles on these topics listed in the PubMed database. Finally, we provide an assessment regarding the clinical use of these ncRNA types, particularly their circulating forms, as predictive BC biomarkers and their potential role as therapy targets to overcome endocrine resistance.

The Role of MicroRNAs in HER2-Positive Breast Cancer: Where We Are and Future Prospective

Simple Summary

Breast cancer is the most diagnosed malignancy in woman worldwide and, despite the availability of new innovative therapies, it remains the first cause of death for tumor in woman. 20% of all breast cancer cases are HER2 positive, meaning that they are characterized by an aberrant expression of the growth factor receptor HER2. This receptor is involved in survival and proliferation mechanisms, conferring to this breast cancer subtype a particular aggressiveness. The introduction of anti-HER2 agents, such as trastuzumab, in the clinical practice, significantly improved the prognosis. However, a great portion of patients is not responsive to this therapy. Thus, cancer research is working to provide new tools to better manage HER2 positive breast cancers, such as biomarkers and therapeutic approaches. MicroRNAs could be used for these purposes. They are small molecules involved in almost all biological processes, including cancer promoting pathways. Researchers consider microRNAs as promising clinical tools because they are easily detectable and stable in both tissues and blood samples, and an increasing body of evidence supports their potential use as targets of therapy, prognostic and predictive biomarkers, or therapeutic agents. This review sums up the most recent scientific publications about microRNAs in HER2 positive breast cancer.

Abstract

Breast cancer that highly expresses human epidermal growth factor receptor 2 (HER2+) represents one of the major breast cancer subtypes, and was associated with a poor prognosis until the introduction of HER2-targeted therapies such as trastuzumab. Unfortunately, up to 30% of patients with HER2+ localized breast cancer continue to relapse, despite treatment. MicroRNAs (miRNAs) are small (approximately 20 nucleotides long) non-coding regulatory oligonucleotides. They function as post-transcriptional regulators of gene expression, binding complementarily to a target mRNA and leading to the arrest of translation or mRNA degradation. In the last two decades, translational research has focused on these small molecules because of their highly differentiated expression patterns in blood and tumor tissue, as well as their potential biological function. In cancer research, they have become pivotal for the thorough understanding of oncogenic biological processes. They might also provide an efficient approach to early monitoring of tumor progression or response to therapy. Indeed, changes in their expression patterns can represent a flag for deeper biological changes. In this review, we sum up the recent literature regarding miRNAs in HER2+ breast cancer, taking into account their potential as powerful prognostic and predictive biomarkers, as well as therapeutic tools.