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Beyond these institutional initiatives, nation-wide molecular screening programs have been launched or are in development.
Recently, many institutions have launched molecular screening programs that apply high-throughput genomic technologies to patients with advanced solid malignancies, including breast cancer, to inform clinical decision-making.
Table? 1 provides an overview of investigational drugs currently in clinical development with putative molecular predictive biomarkers that could be identified through molecular screening programs.
This article provides an overview of the recent molecular insights in breast cancer, including potentially actionable somatic alterations, the technological platforms currently available in a clinical diagnostics setting to detect these alterations, and ongoing institutional or regional molecular screening programs in advanced breast cancer.
Comprehensive molecular screening programs that provide simultaneous testing of multiple biomarkers early in the course of a patient?s disease with access to a broad portfolio of investigational or approved targeted drugs matched to molecular alterations are most likely to advance personalized cancer medicine.
Recognizing that cancer genome sequencing is likely to be integrated into routine clinical decision-making in the near future, many leading cancer research institutions and national cancer agencies have recently launched or are soon to launch broad-scale molecular screening programs for solid tumors, including breast cancer [ 48].
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The use of archived primary tumor specimens or fresh metastatic tumor biopsies for high-throughput testing as part of a molecular screening program is an important unresolved question.
The goal to identify all FH carriers through a large-scale molecular screening program does not seem to be limited by a restriction in terms of access to insurance due to special guidelines for insurance companies on how to deal with risk assessment and genetic screening for FH.
To this end, the Breast International Group BIGG) is constructing a molecular screening program called PRISM-BC that will facilitate the large-scale screening and sequencing of metastatic breast cancer patients, using metastatic biopsies, to determine which patients would be eligible for phase II downstream therapeutic clinical trials conducted under the BIG umbrella using novel targeted agents.
The center would house several existing programs at NIH, including the $113 million Molecular Libraries screening program, a $25 million effort called Therapeutics for Rare and Neglected Diseases, and NCRR's Clinical and Translational Science Awards (CTSA).
A better understanding of these patterns will facilitate the improvements of these fungi in biological control programs, by providing molecular markers for screening programs and candidates for genetic manipulations of virulence and host preferences.
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