The multigene signature MammaPrint impacts on multidisciplinary team decisions in ER+, HER2− early breast cancer

Exner, Ruth; Bagó-Horváth, Zsuzsanna; Bartsch, Rupert; Mittlböck, Martina; Retèl, Valesca P.; Fitzal, Florian; Rudas, Margaretha; Singer, Christian F.; Pfeiler, Georg; Gnant, Michael; Jakesz, R.; Dubsky, Peter

doi:10.1038/bjc.2014.339

Cited by 36 publications

(22 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 Current evidence is based on a few impact studies with relatively small numbers of patients, predominantly describing a hypothesized decrease in the administration of adjuvant CT after 70-GS use in early breast cancer patients. 12,14 Similar results were reported regarding the impact of the 21-gene Recurrence Score (OncotypeDx) on the administration of adjuvant CT. [15][16][17] In addition, high compliance rates with the test results in patients with early-stage ER+, node-negative breast cancer have been reported. 18 Yet, to our knowledge, there are no nationwide studies assessing the impact on the administration of adjuvant CT for either OncotypeDx or the 70-GS.…”

Section: Discussionsupporting

confidence: 68%

“…Various studies have reported the impact of gene expression profiles within cohorts of patients who received the test. 11,12 A theoretical change in adjuvant systemic treatment decisions was reported in ~30% of patients after use of the 70-GS, resulting in a more tailored adjuvant systemic treatment plan for the individual patient. 13 Current evidence is based on a few impact studies with relatively small numbers of patients, predominantly describing a hypothesized decrease in the administration of adjuvant CT after 70-GS use in early breast cancer patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Using a gene expression signature when controversy exists regarding the indication for adjuvant systemic treatment reduces the proportion of patients receiving adjuvant chemotherapy: a nationwide study

Kuijer

Bommel

Drukker

et al. 2016

Genetics in Medicine

View full text Add to dashboard Cite

Methods:Patients within a national guideline directed indication area for 70-GS use who were surgically treated between November 2011 and April 2013 were selected from the Netherlands Cancer Registry database. The effect of 70-GS use on the administration of CT was evaluated in guideline-and age-delineated subgroups addressing potential effect of bias by linear mixed-effect modeling and instrumental variable (IV) analyses.Results: A total of 2,043 patients within the indicated area for 70-GS use were included, of whom 298 received a 70-GS. Without use of the 70-GS, 45% of patients received CT. The 70-GS use was associated with a 9.5% decrease in CT administration (95% confidence interval (CI): −15.7 to −3.3%) in linear mixed-effect model analyses and IV analyses showed similar results (−9.9%; 95% CI: −19.3 to −0.4). Conclusion:In patients in whom the Dutch national guidelines suggest the use of a gene-expression profile, 70-GS use is associated with a 10% decrease in the administration of adjuvant CT. Genet Med advance online publication 19 November 2015

show abstract

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Using a gene expression signature when controversy exists regarding the indication for adjuvant systemic treatment reduces the proportion of patients receiving adjuvant chemotherapy: a nationwide study

Kuijer

Bommel

Drukker

et al. 2016

Genetics in Medicine

View full text Add to dashboard Cite

show abstract

“…This approach has been acknowledged as necessary to define and predict the exquisite complexity of the neoplastic conundrum [43]. Defining the bandwidth of the genomic regulation of neoplasia requires the simultaneous assessment of numerous parameters that circumscribe diverse aspects of tumor biology and facilitate the ‘framing' of clinical behavior [44,45,46]. Numerous successful applications of this principle have advanced the disease management of neoplasia in other sites including breast, liver, colon, prostate and lung cancer [44,47,48,49,50].…”

Section: Discussionmentioning

confidence: 99%

NET Blood Transcript Analysis Defines the Crossing of the Clinical Rubicon: When Stable Disease Becomes Progressive

et al. 2016

View full text Add to dashboard Cite

Background/Aims: A key issue in gastroenteropancreatic neuroendocrine tumors (GEP-NETs) is early identification and prediction of disease progression. Clinical evaluation and imaging are limited due to the lack of sensitivity and disease indolence. We assessed the NETest as a predictive and prognostic marker of progression in a long-term follow-up study. Methods: GEP-NETs (n = 34) followed for a median 4 years (2.2-5.4) were evaluated. WHO tumor grade/stage grade 1: n = 17, grade 2: n = 14, grade 3: n = 1 (for 2, no grade was available); 31 (91%) were stage IV. Baseline and longitudinal imaging and blood biomarkers were available in all, and progression was defined per standard clinical protocols (RECIST 1.0). The NETest was measured by quantitative PCR of blood and multianalyte algorithmic analysis (disease activity scaled 0-100% with low <40% and high activity risk cutoffs >80%); chromogranin A (CgA) was measured by radioimmunoassay (normal <150 µg/l); progression-free survival (PFS) was analyzed by Cox proportional-hazard regression and Kaplan-Meier analysis. Results: At baseline, 100% were NETest positive, and CgA was elevated in 50%. The only baseline variable (Cox modeling) associated with PFS was NETest (hazard ratio = 1.022, 95% confidence interval = 1.005-1.04; p < 0.012). Using Kaplan-Meier analyses, the baseline NETest (>80%) was significantly associated (p = 0.01) with disease progression (median PFS 0.68 vs. 2.78 years with <40% levels). The NETest was more informative (96%) than CgA changes (>25%) in consistently predicting disease alterations (40%, p < 2 × 10^-5, χ² = 18). The NETest had an earlier time point change than imaging (1.02 ± 0.15 years). Baseline NETest levels >40% in stable disease were 100% prognostic of disease progression versus CgA (χ² = 5, p < 0.03). Baseline NETest values <40% accurately (100%) predicted stability over 5 years (p = 0.05, χ² = 3.8 vs. CgA). Conclusion: The NETest correlated with a well-differentiated GEP-NET clinical status. The NETest has predictive and prognostic utility for GEP-NETs identifying clinically actionable alterations ∼1 year before image-based evidence of progression.

show abstract

“…In other cancers, such as breast cancer, the development of molecular markers, especially those based on multianalyte as opposed to monoanalyte delineation of neoplasia, has advanced disease management. 12,13 Such information informs clinical decision making with respect to the choice and the timing of therapy, assessment of effectiveness, and providing, in some instances, prognostic information. 14 …”

Section: Basis For Consensusmentioning

confidence: 99%

Consensus on biomarkers for neuroendocrine tumour disease

Öberg

Modlin

Herder

et al. 2015

The Lancet Oncology

248

221

View full text Add to dashboard Cite

Management of neuroendocrine neoplasia represents a clinical challenge because of its late presentation, lack of treatment options, and limitations in present imaging modalities and biomarkers to guide management. Monoanalyte biomarkers have poor sensitivity, specificity, and predictive ability. A National Cancer Institute summit, held in 2007, on neuroendocrine tumours noted biomarker limitations to be a crucial unmet need in the management of neuroendocrine tumours. A multinational consensus meeting of multidisciplinary experts in neuroendocrine tumours assessed the use of current biomarkers and defined the perquisites for novel biomarkers via the Delphi method. Consensus (at >75%) was achieved for 88 (82%) of 107 assessment questions. The panel concluded that circulating multianalyte biomarkers provide the highest sensitivity and specificity necessary for minimum disease detection and that this type of biomarker had sufficient information to predict treatment effectiveness and prognosis. The panel also concluded that no monoanalyte biomarker of neuroendocrine tumours has yet fulfilled these criteria and there is insufficient information to support the clinical use of miRNA or circulating tumour cells as useful prognostic markers for this disease. The panel considered that trials measuring multianalytes (eg, neuroendocrine gene transcripts) should also identify how such information can optimise the management of patients with neuroendocrine tumours.

show abstract

The multigene signature MammaPrint impacts on multidisciplinary team decisions in ER+, HER2− early breast cancer

Cited by 36 publications

References 22 publications

Using a gene expression signature when controversy exists regarding the indication for adjuvant systemic treatment reduces the proportion of patients receiving adjuvant chemotherapy: a nationwide study

Using a gene expression signature when controversy exists regarding the indication for adjuvant systemic treatment reduces the proportion of patients receiving adjuvant chemotherapy: a nationwide study

NET Blood Transcript Analysis Defines the Crossing of the Clinical Rubicon: When Stable Disease Becomes Progressive

Consensus on biomarkers for neuroendocrine tumour disease

Contact Info

Product

Resources

About