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Published in: Hereditary Cancer in Clinical Practice 1/2013

Open Access 01-12-2013 | Review

Hereditary cancer risk assessment: essential tools for a better approach

Authors: Israel Gomy, Maria Del Pilar Estevez Diz

Published in: Hereditary Cancer in Clinical Practice | Issue 1/2013

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Abstract

Hereditary cancer risk assessment (HCRA) is a multidisciplinary process of estimating probabilities of germline mutations in cancer susceptibility genes and assessing empiric risks of cancer, based on personal and family history. It includes genetic counseling, testing and management of at-risk individuals so that they can make well-informed choices about cancer surveillance, surgical treatment and chemopreventive measures, including biomolecular cancer therapies. Providing patients and family members with an appropriate HCRA will contribute to a better process of making decisions about their personal and family risks of cancer. Following individuals at high risk through screening protocols, reassuring those at low risk, and referring those at increased risk of hereditary cancer to a cancer genetics center may be the best suitable approach of HCRA.
Literature
1.
go back to reference Stadler ZK, Tom P, Robson ME, Weitzel JN, Kauff ND, Hurley KE, Devlin V, Gold B, Klein RJ, Offit K: Genome-wide association studies of cancer. J Clin Oncol 2010, 28: 4255–4267. 10.1200/JCO.2009.25.7816CrossRefPubMedPubMedCentral Stadler ZK, Tom P, Robson ME, Weitzel JN, Kauff ND, Hurley KE, Devlin V, Gold B, Klein RJ, Offit K: Genome-wide association studies of cancer. J Clin Oncol 2010, 28: 4255–4267. 10.1200/JCO.2009.25.7816CrossRefPubMedPubMedCentral
2.
go back to reference Robson ME, Storm CD, Weitzel J, Wollins DS, Offit K: American society of clinical oncology policy statement update: genetic and genomic testing for cancer susceptibility. J Clin Oncol 2010, 28: 893–901. 10.1200/JCO.2009.27.0660CrossRefPubMed Robson ME, Storm CD, Weitzel J, Wollins DS, Offit K: American society of clinical oncology policy statement update: genetic and genomic testing for cancer susceptibility. J Clin Oncol 2010, 28: 893–901. 10.1200/JCO.2009.27.0660CrossRefPubMed
3.
go back to reference Trepanier A, Ahrens M, McKinnon W, Peters J, Stopfer J, Grumet SC, Manley S, Culver JO, Acton R, Larsen-Haidle J, Correia LA, Bennett R, Pettersen B, Ferlita TD, Costalas JW, Hunt K, Donlon S, Skrzynia C, Farrell C, Callif-Daley F, Vockley CW: Genetic cancer risk assessment and counseling: recommendations of the National society of genetic counselors. J Genet Couns 2004, 13: 83–114.CrossRefPubMed Trepanier A, Ahrens M, McKinnon W, Peters J, Stopfer J, Grumet SC, Manley S, Culver JO, Acton R, Larsen-Haidle J, Correia LA, Bennett R, Pettersen B, Ferlita TD, Costalas JW, Hunt K, Donlon S, Skrzynia C, Farrell C, Callif-Daley F, Vockley CW: Genetic cancer risk assessment and counseling: recommendations of the National society of genetic counselors. J Genet Couns 2004, 13: 83–114.CrossRefPubMed
5.
go back to reference Weitzel JN, Blazer KR, Mac Donald DJ, Culver OJ, Offit K: Genetics, genomics and risk assessment: state of the art and future directions in the era of personalized medicine. CA Cancer J Clin 2011, 61: 327–359.PubMedPubMedCentral Weitzel JN, Blazer KR, Mac Donald DJ, Culver OJ, Offit K: Genetics, genomics and risk assessment: state of the art and future directions in the era of personalized medicine. CA Cancer J Clin 2011, 61: 327–359.PubMedPubMedCentral
6.
go back to reference Couch F, DeShano ML, Blackwood MA, Calzone K, Stopfer J, Campeau L, Ganguly A, Rebbeck T, Weber BL: BRCA1 mutations in women attending clinics that evaluate the risk of breast cancer. N Engl J Med 1997, 336: 1409–1415. 10.1056/NEJM199705153362002CrossRefPubMed Couch F, DeShano ML, Blackwood MA, Calzone K, Stopfer J, Campeau L, Ganguly A, Rebbeck T, Weber BL: BRCA1 mutations in women attending clinics that evaluate the risk of breast cancer. N Engl J Med 1997, 336: 1409–1415. 10.1056/NEJM199705153362002CrossRefPubMed
7.
go back to reference Lindor NM, Johnson KJ, Harvey H, Shane Pankratz V, Domchek SM, Hunt K, Wilson M, Cathie Smith M, Couch F: Predicting BRCA1 and BRCA2 gene mutationcarriers: comparison of PENN II model to previous study. Fam Cancer 2010, 9: 495–502. 10.1007/s10689-010-9348-3CrossRefPubMedPubMedCentral Lindor NM, Johnson KJ, Harvey H, Shane Pankratz V, Domchek SM, Hunt K, Wilson M, Cathie Smith M, Couch F: Predicting BRCA1 and BRCA2 gene mutationcarriers: comparison of PENN II model to previous study. Fam Cancer 2010, 9: 495–502. 10.1007/s10689-010-9348-3CrossRefPubMedPubMedCentral
8.
go back to reference Frank TS, Deffenbaugh AM, Reid JE, Hulick M, Ward BE, Lingenfelter B, Gumpper KL, Scholl T, Tavtigian SV, Pruss DR, Critchfield GC: Clinical characteristics of individuals with germline mutations in BRCA1 and BRCA2: analysis of 10,000 individuals. J Clin Oncol 2002, 20: 1480–1490. 10.1200/JCO.20.6.1480CrossRefPubMed Frank TS, Deffenbaugh AM, Reid JE, Hulick M, Ward BE, Lingenfelter B, Gumpper KL, Scholl T, Tavtigian SV, Pruss DR, Critchfield GC: Clinical characteristics of individuals with germline mutations in BRCA1 and BRCA2: analysis of 10,000 individuals. J Clin Oncol 2002, 20: 1480–1490. 10.1200/JCO.20.6.1480CrossRefPubMed
9.
go back to reference Berry DA, Iversen ES Jr, Gudbjartsson DF, Hiller EH, Garber JE, Peshkin BN, Lerman C, Watson P, Lynch HT, Hilsenbeck SG, Rubinstein WS, Hughes KS, Parmigiani G: BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalence of other breast cancer susceptibility genes. J Clin Oncol 2002, 20: 2701–2712. 10.1200/JCO.2002.05.121CrossRefPubMed Berry DA, Iversen ES Jr, Gudbjartsson DF, Hiller EH, Garber JE, Peshkin BN, Lerman C, Watson P, Lynch HT, Hilsenbeck SG, Rubinstein WS, Hughes KS, Parmigiani G: BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalence of other breast cancer susceptibility genes. J Clin Oncol 2002, 20: 2701–2712. 10.1200/JCO.2002.05.121CrossRefPubMed
10.
go back to reference Berry DA, Parmigiani G, Sanchez J, Schildkraut J, Winer E: Probability of carrying a mutation of breast-ovarian cancer gene BRCA1 based on family history. J Natl Cancer Inst 1997, 89: 227–238. 10.1093/jnci/89.3.227CrossRefPubMed Berry DA, Parmigiani G, Sanchez J, Schildkraut J, Winer E: Probability of carrying a mutation of breast-ovarian cancer gene BRCA1 based on family history. J Natl Cancer Inst 1997, 89: 227–238. 10.1093/jnci/89.3.227CrossRefPubMed
11.
go back to reference Parmigiani G, Berry D, Aguilar O: Determining carrier probabilities for breast cancer-susceptibility genes BRCA1 and BRCA2. Am J Hum Genet 1998, 62: 145–158. 10.1086/301670CrossRefPubMedPubMedCentral Parmigiani G, Berry D, Aguilar O: Determining carrier probabilities for breast cancer-susceptibility genes BRCA1 and BRCA2. Am J Hum Genet 1998, 62: 145–158. 10.1086/301670CrossRefPubMedPubMedCentral
12.
go back to reference Tyrer J, Duffy SW, Cuzick J: A breast cancer prediction model incorporating familial and personal risk factors. Stat Med 2004, 23: 1111–1130. 10.1002/sim.1668CrossRefPubMed Tyrer J, Duffy SW, Cuzick J: A breast cancer prediction model incorporating familial and personal risk factors. Stat Med 2004, 23: 1111–1130. 10.1002/sim.1668CrossRefPubMed
13.
go back to reference Antoniou AC, Pharoah PP, Smith P, Easton DF: The BOADICEA model of genetic susceptibility to breast and ovarian cancer. Br J Cancer 2004, 91: 1580–1590.PubMedPubMedCentral Antoniou AC, Pharoah PP, Smith P, Easton DF: The BOADICEA model of genetic susceptibility to breast and ovarian cancer. Br J Cancer 2004, 91: 1580–1590.PubMedPubMedCentral
14.
go back to reference Wijnen JT, Vasen HFA, Khan PM, Zwinderman AH, van der Klift H, Mulder A, Tops C, Møller P, Fodde R: Clinical findings with implications for genetic testing in families with clustering of colorectal cancer. N Engl J Med 1998, 339: 511–518. 10.1056/NEJM199808203390804CrossRefPubMed Wijnen JT, Vasen HFA, Khan PM, Zwinderman AH, van der Klift H, Mulder A, Tops C, Møller P, Fodde R: Clinical findings with implications for genetic testing in families with clustering of colorectal cancer. N Engl J Med 1998, 339: 511–518. 10.1056/NEJM199808203390804CrossRefPubMed
15.
go back to reference Chen S, Wang W, Lee S, Nafa K, Lee J, Romans K, Watson P, Gruber SB, Euhus D, Kinzler KW, Jass J, Gallinger S, Lindor NM, Casey G, Ellis N, Giardiello FM, Offit K, Parmigiani G: Colon cancer family registry: prediction of germline mutations and cancer risk in the Lynch syndrome. JAMA 2006, 296: 1479–1487. 10.1001/jama.296.12.1479CrossRefPubMedPubMedCentral Chen S, Wang W, Lee S, Nafa K, Lee J, Romans K, Watson P, Gruber SB, Euhus D, Kinzler KW, Jass J, Gallinger S, Lindor NM, Casey G, Ellis N, Giardiello FM, Offit K, Parmigiani G: Colon cancer family registry: prediction of germline mutations and cancer risk in the Lynch syndrome. JAMA 2006, 296: 1479–1487. 10.1001/jama.296.12.1479CrossRefPubMedPubMedCentral
16.
go back to reference Barnetson RA, Tenesa A, Farrington SM, Nicholl ID, Cetnarskyj R, Porteous ME, Campbell H, Dunlop MG: Identification and survival of carriers of mutations in DNA mismatchrepair genes in colon cancer. N Engl J Med 2006, 354: 2751–2763. 10.1056/NEJMoa053493CrossRefPubMed Barnetson RA, Tenesa A, Farrington SM, Nicholl ID, Cetnarskyj R, Porteous ME, Campbell H, Dunlop MG: Identification and survival of carriers of mutations in DNA mismatchrepair genes in colon cancer. N Engl J Med 2006, 354: 2751–2763. 10.1056/NEJMoa053493CrossRefPubMed
17.
go back to reference Kastrinos F, Steyerberg EW, Mercado R, Balmaña J, Holter S, Gallinger S, Siegmund KD, Church JM, Jenkins MA, Lindor NM, Thibodeau SN, Burbidge LA, Wenstrup RJ, Syngal S: The PREMM(1,2,6) model predicts risk of MLH1, MSH2, and MSH6 germline mutations based on cancer history. Gastroenterology 2011, 140: 73–81. 10.1053/j.gastro.2010.08.021CrossRefPubMed Kastrinos F, Steyerberg EW, Mercado R, Balmaña J, Holter S, Gallinger S, Siegmund KD, Church JM, Jenkins MA, Lindor NM, Thibodeau SN, Burbidge LA, Wenstrup RJ, Syngal S: The PREMM(1,2,6) model predicts risk of MLH1, MSH2, and MSH6 germline mutations based on cancer history. Gastroenterology 2011, 140: 73–81. 10.1053/j.gastro.2010.08.021CrossRefPubMed
18.
go back to reference Vasen HF, Watson P, Mecklin JP, Lynch HT: New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International collaborative group on HNPCC. Gastroenterology 1999, 116: 1453–1456. 10.1016/S0016-5085(99)70510-XCrossRefPubMed Vasen HF, Watson P, Mecklin JP, Lynch HT: New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International collaborative group on HNPCC. Gastroenterology 1999, 116: 1453–1456. 10.1016/S0016-5085(99)70510-XCrossRefPubMed
19.
go back to reference Umar A, Boland CR, Terdiman JP, Syngal S, de la Chapelle A, Rüschoff J, Fishel R, Lindor NM, Burgart LJ, Hamelin R, Hamilton SR, Hiatt RA, Jass J, Lindblom A, Lynch HT, Peltomaki P, Ramsey SD, Rodriguez-Bigas MA, Vasen HF, Hawk ET, Barrett JC, Freedman AN, Srivastava S: Revised Bethesda guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 2004, 96: 261–268. 10.1093/jnci/djh034CrossRefPubMedPubMedCentral Umar A, Boland CR, Terdiman JP, Syngal S, de la Chapelle A, Rüschoff J, Fishel R, Lindor NM, Burgart LJ, Hamelin R, Hamilton SR, Hiatt RA, Jass J, Lindblom A, Lynch HT, Peltomaki P, Ramsey SD, Rodriguez-Bigas MA, Vasen HF, Hawk ET, Barrett JC, Freedman AN, Srivastava S: Revised Bethesda guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 2004, 96: 261–268. 10.1093/jnci/djh034CrossRefPubMedPubMedCentral
20.
go back to reference Li PP, Fraumeni JF: Soft tissue sarcomas, breast cancer and other neoplasms: a familial syndrome? Ann Int Med 1969, 71: 747–752. 10.7326/0003-4819-71-4-747CrossRefPubMed Li PP, Fraumeni JF: Soft tissue sarcomas, breast cancer and other neoplasms: a familial syndrome? Ann Int Med 1969, 71: 747–752. 10.7326/0003-4819-71-4-747CrossRefPubMed
21.
go back to reference Chompret A, Brugieres L, Ronsin M, Gardes M, Dessarps-Freichey F, Abel A, Hua D, Ligot L, Dondon MG, Bressac-de Paillerets B, Frébourg T, Lemerle J, Bonaïti-Pellié C, Feunteun J: P53 germline mutations in childhood cancers and cancer risk for carrier individuals. Br J Cancer 2000, 82: 1932–1937.CrossRefPubMedPubMedCentral Chompret A, Brugieres L, Ronsin M, Gardes M, Dessarps-Freichey F, Abel A, Hua D, Ligot L, Dondon MG, Bressac-de Paillerets B, Frébourg T, Lemerle J, Bonaïti-Pellié C, Feunteun J: P53 germline mutations in childhood cancers and cancer risk for carrier individuals. Br J Cancer 2000, 82: 1932–1937.CrossRefPubMedPubMedCentral
23.
go back to reference Tan MH, Mester J, Peterson C, Yang Y, Chen JL, Rybicki LA, Milas K, Pederson H, Remzi B, Orloff MS, Eng C: A clinical scoring system for selection of patients for PTEN mutation testing is proposed on the basis of a prospective study of 3042 probands. Am J Hum Genet 2011, 88: 42–56. 10.1016/j.ajhg.2010.11.013CrossRefPubMedPubMedCentral Tan MH, Mester J, Peterson C, Yang Y, Chen JL, Rybicki LA, Milas K, Pederson H, Remzi B, Orloff MS, Eng C: A clinical scoring system for selection of patients for PTEN mutation testing is proposed on the basis of a prospective study of 3042 probands. Am J Hum Genet 2011, 88: 42–56. 10.1016/j.ajhg.2010.11.013CrossRefPubMedPubMedCentral
24.
go back to reference Wang W, Niendorf KB, Patel D, Blackford A, Marroni F, Sober AJ, Parmigiani G, Tsao H: Estimating CDKN2A carrier probability and personalizing cancer risk assessments in hereditary melanoma using MelaPRO. Cancer Res 2010, 70: 552–559. 10.1158/0008-5472.CAN-09-2653CrossRefPubMedPubMedCentral Wang W, Niendorf KB, Patel D, Blackford A, Marroni F, Sober AJ, Parmigiani G, Tsao H: Estimating CDKN2A carrier probability and personalizing cancer risk assessments in hereditary melanoma using MelaPRO. Cancer Res 2010, 70: 552–559. 10.1158/0008-5472.CAN-09-2653CrossRefPubMedPubMedCentral
25.
go back to reference Dinh TA, Rosner BI, Atwood JC, Boland CR, Syngal S, Vasen HF, Gruber SB, Burt RW: Health benefits and cost-effectiveness of primary genetic screening for Lynch syndrome in the general population. Cancer Prev Res (Phila) 2011, 4: 9–22. 10.1158/1940-6207.CAPR-10-0262CrossRef Dinh TA, Rosner BI, Atwood JC, Boland CR, Syngal S, Vasen HF, Gruber SB, Burt RW: Health benefits and cost-effectiveness of primary genetic screening for Lynch syndrome in the general population. Cancer Prev Res (Phila) 2011, 4: 9–22. 10.1158/1940-6207.CAPR-10-0262CrossRef
26.
go back to reference Kwon JS, Gutierrez-Barrera AM, Young D, Sun CC, Daniels MS, Lu KH, Arun B: Expanding the criteria for BRCA mutation testing in breast cancer survivors. J Clin Oncol 2010, 28: 4214–4220. 10.1200/JCO.2010.28.0719CrossRefPubMed Kwon JS, Gutierrez-Barrera AM, Young D, Sun CC, Daniels MS, Lu KH, Arun B: Expanding the criteria for BRCA mutation testing in breast cancer survivors. J Clin Oncol 2010, 28: 4214–4220. 10.1200/JCO.2010.28.0719CrossRefPubMed
27.
go back to reference National Comprehensive Cancer Network: NCCN practice guidelines V.1.2013: genetic/familial high-risk assessment: breast and ovarian. Fort Washington, PA: National Comprehensive Cancer Network; 2013. http://www.nccn.org National Comprehensive Cancer Network: NCCN practice guidelines V.1.2013: genetic/familial high-risk assessment: breast and ovarian. Fort Washington, PA: National Comprehensive Cancer Network; 2013. http://​www.​nccn.​org
28.
go back to reference National Comprehensive Cancer Network: NCCN practice guidelines V.2.2012: colorectal cancer screening. Fort Washington, PA: National Comprehensive Cancer Network; 2012. http://www.nccn.org National Comprehensive Cancer Network: NCCN practice guidelines V.2.2012: colorectal cancer screening. Fort Washington, PA: National Comprehensive Cancer Network; 2012. http://​www.​nccn.​org
29.
go back to reference Hampel H, Sweet K, Westman JA, Offit K, Eng C: Referral for cancer genetics consultation: a review and compilation of risk assessment criteria. J Med Genet 2004, 41: 81–91. 10.1136/jmg.2003.010918CrossRefPubMedPubMedCentral Hampel H, Sweet K, Westman JA, Offit K, Eng C: Referral for cancer genetics consultation: a review and compilation of risk assessment criteria. J Med Genet 2004, 41: 81–91. 10.1136/jmg.2003.010918CrossRefPubMedPubMedCentral
30.
go back to reference Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 1989, 81: 1879–1886. 10.1093/jnci/81.24.1879CrossRefPubMed Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 1989, 81: 1879–1886. 10.1093/jnci/81.24.1879CrossRefPubMed
31.
go back to reference Claus EB, Risch N, Thompson WD: Autosomal dominant inheritance of earlyonset breast cancer: implications for risk prediction. Cancer 1994, 73: 643–651. 10.1002/1097-0142(19940201)73:3<643::AID-CNCR2820730323>3.0.CO;2-5CrossRefPubMed Claus EB, Risch N, Thompson WD: Autosomal dominant inheritance of earlyonset breast cancer: implications for risk prediction. Cancer 1994, 73: 643–651. 10.1002/1097-0142(19940201)73:3<643::AID-CNCR2820730323>3.0.CO;2-5CrossRefPubMed
33.
go back to reference Fletcher O, Houlston RS: Architecture of inherited susceptibility to common cancer. Nature Rev Cancer 2010, 10: 353–361.CrossRef Fletcher O, Houlston RS: Architecture of inherited susceptibility to common cancer. Nature Rev Cancer 2010, 10: 353–361.CrossRef
34.
go back to reference National Institute for Health and Care Excellence (NICE): Classification and care of people at risk of familial breast cancer and management of breast cancer and related risks in people with a family history of breast cancer. http://guidance.nice.org.uk/cg164 National Institute for Health and Care Excellence (NICE): Classification and care of people at risk of familial breast cancer and management of breast cancer and related risks in people with a family history of breast cancer. http://​guidance.​nice.​org.​uk/​cg164
35.
go back to reference Garber J, Zon R, Weitzel J: Genetic counseling: an indispensable step in the genetic testing process. J Oncol Pract 2008,4(2):96–98.CrossRef Garber J, Zon R, Weitzel J: Genetic counseling: an indispensable step in the genetic testing process. J Oncol Pract 2008,4(2):96–98.CrossRef
36.
go back to reference Hodgson SV, Foulkes WD, Eng C, Maher ER: A practical guide to human cancer genetics. 3rd edition. Cambridge, UK: Cambridge University Press; 2007. Hodgson SV, Foulkes WD, Eng C, Maher ER: A practical guide to human cancer genetics. 3rd edition. Cambridge, UK: Cambridge University Press; 2007.
37.
go back to reference Green RC, Berg JS, Grody WW, Kalia SS, Korf BR, Martin CL, McGuire AL, Nussbaum RL, O’Daniel JM, Ormond KE, Rehm HL, Watson MS, Williams MS, Biesecker LG: ACMG recommendations for reporting of incidental findings in clinical exome and genome sequencing. Genet Med 2013,15(7):565–574. 10.1038/gim.2013.73CrossRefPubMedPubMedCentral Green RC, Berg JS, Grody WW, Kalia SS, Korf BR, Martin CL, McGuire AL, Nussbaum RL, O’Daniel JM, Ormond KE, Rehm HL, Watson MS, Williams MS, Biesecker LG: ACMG recommendations for reporting of incidental findings in clinical exome and genome sequencing. Genet Med 2013,15(7):565–574. 10.1038/gim.2013.73CrossRefPubMedPubMedCentral
38.
go back to reference Ministério da Saúde. Instituto Nacional de Câncer (INCA): Rede nacional de câncer familial: manual operacional. Rio de Janeiro, Brazil: Coordenação de Educação (CEDC); 2009. Ministério da Saúde. Instituto Nacional de Câncer (INCA): Rede nacional de câncer familial: manual operacional. Rio de Janeiro, Brazil: Coordenação de Educação (CEDC); 2009.
Metadata
Title
Hereditary cancer risk assessment: essential tools for a better approach
Authors
Israel Gomy
Maria Del Pilar Estevez Diz
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Hereditary Cancer in Clinical Practice / Issue 1/2013
Electronic ISSN: 1897-4287
DOI
https://doi.org/10.1186/1897-4287-11-16

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