Strong impact of MammaPrint and BluePrint on treatment decisions in luminal early breast cancer: results of the WSG-PRIMe study
| Autor: | R, Wuerstlein, R, Kates, O, Gluz, E M, Grischke, C, Schem, M, Thill, S, Hasmueller, A, Köhler, B, Otremba, F, Griesinger, C, Schindlbeck, A, Trojan, F, Otto, M, Knauer, R, Pusch, N, Harbeck |
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| Přispěvatelé: | WSG-PRIMe investigators in Germany, Austria, Switzerland |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Cancer Research Receptor ErbB-2 Cost-Benefit Analysis medicine.medical_treatment Molecular profiling Breast cancer 0302 clinical medicine MammaPrint In Situ Hybridization Fluorescence Early breast cancer Aged 80 and over medicine.diagnostic_test Middle Aged Diagnostic test BluePrint Clinical Trial 3. Good health Gene Expression Regulation Neoplastic Clinical therapy Treatment Outcome Receptors Estrogen Oncology Chemotherapy Adjuvant 030220 oncology & carcinogenesis Anxiety Female medicine.symptom Receptors Progesterone Risk assessment Adult medicine.medical_specialty Decision Making Breast Neoplasms 03 medical and health sciences Internal medicine medicine Humans ddc:610 Aged Chemotherapy business.industry medicine.disease Decision impact 030104 developmental biology Treatment decision making Transcriptome business |
| Zdroj: | Breast Cancer Research and Treatment |
| Popis: | Purpose: The WSG-PRIMe Study prospectively evaluated the impact of the 70-gene signature MammaPrint® (MP) and the 80-gene molecular subtyping assay BluePrint® on clinical therapy decisions in luminal early breast cancer. Methods: 452 hormone receptor (HR)-positive and HER2-negative patients were recruited (N0, N1). Physicians provided initial therapy recommendations based on clinicopathological factors. After prospective risk classification by MammaPrint/BluePrint was revealed, post-test treatment recommendations and actual treatment were recorded. Decisional Conflict and anxiety were measured by questionnaires. Results: Post-test switch (in chemotherapy (CT) recommendation) occurred in 29.1% of cases. Overall, physician adherence to MP risk assessment was 92.3% for low-risk and 94.3% for high-risk MP scores. Adherence was remarkably high in “discordant” groups: 74.7% of physicians initially recommending CT switched to CT omission following low-risk MP scores; conversely, 88.9% of physicians initially recommending CT omission switched to CT recommendations following high-risk MP scores. Most patients (99.2%) recommended to forgo CT post-test and 21.3% of patients with post-test CT recommendations did not undergo CT; among MP low-risk patients with pre-test and post-test CT recommendations, 40% did not actually undergo CT. Luminal subtype assessment by BluePrint was discordant with IHC assessment in 34% of patients. Patients’ State Anxiety scores improved significantly overall, particularly in MP low-risk patients. Trait Anxiety scores increased slightly in MP high risk and decreased slightly in MP low-risk patients. Conclusions: MammaPrint and BluePrint test results strongly impacted physicians’ therapy decisions in luminal EBC with up to three involved lymph nodes. The high adherence to genetically determined risk assessment represents a key prerequisite for achieving a personalized cost-effective approach to disease management of early breast cancer. |
| Databáze: | OpenAIRE |
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