Liu ZY, Chen R. Precision therapy for driver gene mutations in breast cancer: Current landscape and future perspectives. World J Clin Oncol 2026; 17(4): 117540 [DOI: 10.5306/wjco.v17.i4.117540]
Corresponding Author of This Article
Zhi-Yong Liu, MD, Breast Diagnosis and Treatment Center, First Affiliated Hospital of Gannan Medical University, No. 128 Jinling Road, Huangjin Technology Development Zone, Ganzhou 341000, Jiangxi Province, China. barton123321@163.com
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Medicine, Research & Experimental
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Apr 24, 2026 (publication date) through Apr 22, 2026
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World Journal of Clinical Oncology
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2218-4333
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Liu ZY, Chen R. Precision therapy for driver gene mutations in breast cancer: Current landscape and future perspectives. World J Clin Oncol 2026; 17(4): 117540 [DOI: 10.5306/wjco.v17.i4.117540]
World J Clin Oncol. Apr 24, 2026; 17(4): 117540 Published online Apr 24, 2026. doi: 10.5306/wjco.v17.i4.117540
Precision therapy for driver gene mutations in breast cancer: Current landscape and future perspectives
Zhi-Yong Liu, Ran Chen
Zhi-Yong Liu, Ran Chen, Breast Diagnosis and Treatment Center, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Author contributions: Liu ZY designed the article format, wrote the manuscript, and revised the original draft; Chen R reviewed and searched the literature; and all authors studied and approved the final version of this manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Zhi-Yong Liu, MD, Breast Diagnosis and Treatment Center, First Affiliated Hospital of Gannan Medical University, No. 128 Jinling Road, Huangjin Technology Development Zone, Ganzhou 341000, Jiangxi Province, China. barton123321@163.com
Received: December 10, 2025 Revised: January 6, 2026 Accepted: February 10, 2026 Published online: April 24, 2026 Processing time: 132 Days and 23.7 Hours
Abstract
The high heterogeneity of breast cancer necessitates individualized treatment. The widespread application of next-generation sequencing has established driver gene mutation identification as the cornerstone of precision therapy in breast cancer. These mutations drive tumor development and progression by constitutively activating core signaling pathways, such as phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin, cell cycle regulation, and DNA damage repair. This article systematically reviews the biological functions, clinical detection methods, and corresponding targeted therapeutic strategies for key driver genes in breast cancer (e.g., PIK3CA, ESR1, BRCA1/2, and AKT1). In particular, the article focuses on key evidence from clinical trials for relevant targeted agents, such as alpelisib, olaparib, and elacestrant. Concurrently, it delves into the primary molecular mechanisms underlying acquired resistance and strategies for dynamic monitoring. The article prospectively explores future directions involving multi-omics integration, liquid biopsy, artificial intelligence, and novel therapeutic modalities in overcoming resistance and optimizing treatment sequences. Driver gene mutation-guided precision therapy is profoundly reshaping the therapeutic landscape of breast cancer, significantly improving the survival of patients.
Core Tip: This article delineates the paradigm of driver gene mutation-guided precision therapy in breast cancer. We synthesize the clinical application of targeting key mutations (e.g., PIK3CA, ESR1, BRCA1/2) and analyze the complex landscape of acquired resistance. Critically, we propose a forward-looking framework integrating multi-omics, liquid biopsy, and artificial intelligence to dynamically navigate treatment. The article underscores the necessity of evolving from static biomarker testing towards a proactive, digitally-enabled ecosystem to overcome resistance and optimize sequential therapy, ultimately aiming for sustained patient benefit.
