Abstract
Purpose: We investigated in a single institution series of 124 women with operable breast cancer whether tumor clinicopathological features could predict the 70-gene signature (Mammaprint®, MP) results, and whether MP results could help to make decisions for the use of chemotherapy (CT) in patients (pts) with ER positive breast cancer beyond recommendations of international guidelines. Results: Among the 68 ER/PgR positive, HER2 negative tumors, Ki-67≥20% was the only significant predictor of a high risk-MP among standard clinicopathological features. In candidates for endocrine therapy with undetermined benefit from CT according to international guidelines, MP results would have led to different treatment decisions in 13/46 (28%) and in 20/68 (29%) pts according to NCCN and St. Gallen recommendations, respectively. Conclusions: Ki-67 independently predicted high risk-MP in ER/PgR positive, HER2 negative tumors. MP results would have led to discordant treatment recommendations in about 30% of cases, generally increasing indication rate for CT. The results of large randomized trials are warranted in order to understand whether we should rely on multigene assays rather than on standard clinicopathological features for treatment decisions.
| Original language | English |
|---|---|
| Pages (from-to) | 419-424 |
| Number of pages | 6 |
| Journal | Breast |
| Volume | 22 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Aug 2013 |
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Keywords
- Adjuvant systemic treatment
- Breast cancer
- Mammaprint
- Multigene signatures
- Predicting factors
- Treatment guidelines
ASJC Scopus subject areas
- Surgery
Cite this
Potential impact of the 70-gene signature in the choice of adjuvant systemic treatment for ER positive, HER2 negative tumors : A single institution experience. / Torrisi, R.; Garcia-Etienne, C. A.; Losurdo, A.; Morenghi, E.; Di Tommaso, L.; Gatzemeier, W.; Sagona, A.; Fernandes, B.; Rossetti, C.; Eboli, M.; Rubino, A.; Barbieri, E.; Andreoli, C.; Orefice, S.; Gandini, C.; Rota, S.; Zuradelli, M.; Masci, G.; Santoro, A.; Tinterri, C.
In: Breast, Vol. 22, No. 4, 08.2013, p. 419-424.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Potential impact of the 70-gene signature in the choice of adjuvant systemic treatment for ER positive, HER2 negative tumors
T2 - A single institution experience
AU - Torrisi, R.
AU - Garcia-Etienne, C. A.
AU - Losurdo, A.
AU - Morenghi, E.
AU - Di Tommaso, L.
AU - Gatzemeier, W.
AU - Sagona, A.
AU - Fernandes, B.
AU - Rossetti, C.
AU - Eboli, M.
AU - Rubino, A.
AU - Barbieri, E.
AU - Andreoli, C.
AU - Orefice, S.
AU - Gandini, C.
AU - Rota, S.
AU - Zuradelli, M.
AU - Masci, G.
AU - Santoro, A.
AU - Tinterri, C.
PY - 2013/8
Y1 - 2013/8
N2 - Purpose: We investigated in a single institution series of 124 women with operable breast cancer whether tumor clinicopathological features could predict the 70-gene signature (Mammaprint®, MP) results, and whether MP results could help to make decisions for the use of chemotherapy (CT) in patients (pts) with ER positive breast cancer beyond recommendations of international guidelines. Results: Among the 68 ER/PgR positive, HER2 negative tumors, Ki-67≥20% was the only significant predictor of a high risk-MP among standard clinicopathological features. In candidates for endocrine therapy with undetermined benefit from CT according to international guidelines, MP results would have led to different treatment decisions in 13/46 (28%) and in 20/68 (29%) pts according to NCCN and St. Gallen recommendations, respectively. Conclusions: Ki-67 independently predicted high risk-MP in ER/PgR positive, HER2 negative tumors. MP results would have led to discordant treatment recommendations in about 30% of cases, generally increasing indication rate for CT. The results of large randomized trials are warranted in order to understand whether we should rely on multigene assays rather than on standard clinicopathological features for treatment decisions.
AB - Purpose: We investigated in a single institution series of 124 women with operable breast cancer whether tumor clinicopathological features could predict the 70-gene signature (Mammaprint®, MP) results, and whether MP results could help to make decisions for the use of chemotherapy (CT) in patients (pts) with ER positive breast cancer beyond recommendations of international guidelines. Results: Among the 68 ER/PgR positive, HER2 negative tumors, Ki-67≥20% was the only significant predictor of a high risk-MP among standard clinicopathological features. In candidates for endocrine therapy with undetermined benefit from CT according to international guidelines, MP results would have led to different treatment decisions in 13/46 (28%) and in 20/68 (29%) pts according to NCCN and St. Gallen recommendations, respectively. Conclusions: Ki-67 independently predicted high risk-MP in ER/PgR positive, HER2 negative tumors. MP results would have led to discordant treatment recommendations in about 30% of cases, generally increasing indication rate for CT. The results of large randomized trials are warranted in order to understand whether we should rely on multigene assays rather than on standard clinicopathological features for treatment decisions.
KW - Adjuvant systemic treatment
KW - Breast cancer
KW - Mammaprint
KW - Multigene signatures
KW - Predicting factors
KW - Treatment guidelines
UR - http://www.scopus.com/inward/record.url?scp=84879784816&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879784816&partnerID=8YFLogxK
U2 - 10.1016/j.breast.2013.03.013
DO - 10.1016/j.breast.2013.03.013
M3 - Article
C2 - 23643803
AN - SCOPUS:84879784816
VL - 22
SP - 419
EP - 424
JO - Breast
JF - Breast
SN - 0960-9776
IS - 4
ER -