101IN - Putting genomics into clinical practice

Date 01 October 2012
Event ESMO Congress 2012
Session ESMO-ASCO Joint symposium: Genomics in breast cancer: Opening new doors
Topics Breast Cancer
Personalised Medicine
Translational Research
Presenter Ana Maria Gonzalez-Angulo
Authors A.M. Gonzalez-Angulo
  • Department Of Breast Medical Oncology, The University of Texas, 77030 - Houston/US

Abstract

Over the last decade we have seen advances in breast cancer including the realization that breast cancer is not a homogenous disease but rather a conglomeration of a number of subtypes including luminal A, luminal B, HER2 enriched and basal like subtypes; each associated with a different prognostic outcome. The development of high-throughput techniques such as gene expression profiling platforms that are able to not only predict prognostic outcome but also, as the data indicate, predict for responsiveness to chemotherapy and thus being able to identify groups who may not require chemotherapy. Such data led to the endorsement for the use of Oncotype DX RS by ASCO and NCCN as both a prediction and prognostic tool among women with estrogen receptor-positive node negative breast cancer. The two prototypes that have the most clinical data reported and are being evaluated in prospective clinical trials are MammaPrint (Agendia, Inc., Amsterdam, The Netherlands) and Oncotype DX (Genomic Health, Inc., Santa Clara, CA). However the question remains as to whether such tools would be useful among women with node-positive disease. Women with node-positive disease have traditionally been considered to be at highest risk of recurrence. However, multigene assays may be able to identify a group of women with endocrine responsive, node positive disease that may not require chemotherapy thus avoiding the associated toxicities. Prospective trials will be essential to accurately identify the groups that will and will not benefit from chemotherapy. Until results of such studies are available the current guidelines still endorse the use of adjuvant chemotherapy among all women with node positive disease.

Disclosure

All authors have declared no conflicts of interest.