Clinical Utility of Multigene Profiling Assays in Early-Stage Breast Cancer

Chang, Martin C.; Souter, Lesley; Kamel‐Reid, Suzanne; Rutherford, Michael N.; Bedard, Philippe L.; Trudeau, Maureen; Hart, Jennifer; Eisen, Andrea

doi:10.3747/co.24.3595

Cited by 14 publications

(10 citation statements)

References 41 publications

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“…Multigene signature panels have become widely used in evaluating patients with early stage (I or II) breast cancer, with the hope of better assessing prognosis and guiding therapy. [1][2][3][4] The 2 most prominent multigene signature panels (MSPs), Oncotype DX (ODX, a 21 gene panel comprising genes involved in estrogen signaling) 5 and MammaPrint (MP, a panel based on the Amsterdam 70-gene breast cancer gene signature) 6 both have demonstrated efficacy for evaluation of recurrence risk in women with stage I, II, or IIIa breast cancer with or without positive lymph nodes.…”

mentioning

confidence: 99%

Multigene Signature Panels and Breast Cancer Therapy: Patterns of Use and Impact on Clinical Decision Making

Bhutiani

Egger

Ajkay

et al. 2018

Journal of the American College of Surgeons

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confidence: 99%

Multigene Signature Panels and Breast Cancer Therapy: Patterns of Use and Impact on Clinical Decision Making

Bhutiani

Egger

Ajkay

et al. 2018

Journal of the American College of Surgeons

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“…Recent recommendations from Cancer Care Ontario specify that clinicians could offer gep testing to eligible breast cancer patients. A qualifying statement that accompanies the recommendation specifies that gep testing should not be requested "if the patient's management plan has been decided based on clinical, pathologic, and/or patient-related factors and is unlikely to change" 9 .…”

Section: Introductionmentioning

confidence: 99%

Uptake of a 21-Gene Expression Assay in Breast Cancer Practice: Views of Academic and Community-Based Oncologists

et al. 2017

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Purpose Advances in personalized medicine have produced novel tests and treatment options for women with breast cancer. Relatively little is known about the process by which such tests are adopted into oncology practice. The objectives of the present study were to understand the experiences of medical oncologists with multigene expression profile (gep) tests, including their adoption into practice in early-stage breast cancer, and the perceptions of the oncologists about the influence of test results on treatment decision-making. MethodsWe conducted a qualitative descriptive study involving interviews with medical oncologists from academic and community cancer centres or hospitals in 8 communities in Ontario. A 21-gene breast cancer assay was used as the example of gep testing. Qualitative analytic techniques were used to identify the main themes. ResultsOf 28 oncologists who were approached, 21 (75%) participated in the study [median age: 43 years; 12 women (57%)]. Awareness and knowledge of gep testing were derived from several sources: international scientific meetings, participation in clinical studies, discussions with respected colleagues, and manufacturer-sponsored meetings. Oncologists observed that incorporating gep testing into their clinical practice resulted in several changes, including longer consultation times, second visits, and taking steps to minimize treatment delays. Oncologists expressed divergent opinions about the strength of evidence and added value of gep testing in guiding treatment decisions.Conclusions Incorporation of gep testing into clinical practice in early-stage breast cancer required oncologists to make changes to their usual routines. The opinions of oncologists about the quality of evidence underpinning the test affected how much weight they gave to test results in treatment decision-making.

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“…Based solely on traditional clinical-pathological characteristics it is not possible to reliably identify the high risk patients that would potentially benefit from adjuvant chemotherapy. Multigene signatures represent an important progress in optimal selection of these patients 41. Their clinical utility for risk prediction was confirmed in different clinical studies.…”

Section: Discussionmentioning

confidence: 89%

Multigene expression signatures in early hormone receptor positive HER 2 negative breast cancer

Ovcaricek

Takač

Matos

2019

Radiology and Oncology

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Background The standard treatment of hormone receptor positive, HER2 negative early breast cancer (BC) is surgery followed by adjuvant systemic therapy either with endocrine therapy alone or with the addition of chemotherapy followed by endocrine therapy. Adjuvant systemic therapy reduces the risk of recurrence and death from BC. Whether an individual patient will benefit from adjuvant chemotherapy is an important clinical decision. Decisions that rely solely on clinical-pathological factors can often lead to overtreatment. Multigene signatures represent an important progress in optimal selection of high risk patients that might benefit from the addition of chemotherapy to adjuvant endocrine therapy. Conclusions Several signatures are already commercially available and also accepted by international guidelines. Oncotype DX and MammaPrint have been most extensively validated and supported by level IA evidence.

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Clinical Utility of Multigene Profiling Assays in Early-Stage Breast Cancer

Abstract: Background This clinical practice guideline was developed to determine the level of evidence supporting the

Cited by 14 publications

References 41 publications

Multigene Signature Panels and Breast Cancer Therapy: Patterns of Use and Impact on Clinical Decision Making

Multigene Signature Panels and Breast Cancer Therapy: Patterns of Use and Impact on Clinical Decision Making

Uptake of a 21-Gene Expression Assay in Breast Cancer Practice: Views of Academic and Community-Based Oncologists

Multigene expression signatures in early hormone receptor positive HER 2 negative breast cancer

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