Journal: NPJ breast cancer
This publication reviews how hormone receptor–positive, HER2‑negative breast cancer changes under the selective pressure of therapy and argues that treatment must adapt in real time using dynamic biomarkers rather than static, baseline measurements.
The authors summarize several emerging biomarker approaches that can be repeatedly assessed over the disease course:
- Tissue and liquid biopsies to monitor evolving tumor genomics and other molecular features.
- Metabolic imaging to track functional changes in tumor activity and treatment response.
- Microbiome profiling to capture host-related factors that may influence therapy sensitivity or resistance.
They compare how these tools are being developed and used in academic vs industry settings, highlighting differences in trial design, implementation, and regulatory/operational constraints.
Overall, the article calls for a cultural and structural shift in oncology clinical trials toward adaptive, biomarker-driven strategies that anticipate and preempt resistance rather than reacting only after clinical progression.