The Changing Role of Gene-Expression Profiling in the Era of De-escalating Adjuvant Chemotherapy in Early-Stage Breast Cancer
| Autor: | J E C van Steenhoven, K. Schreuder, P. J. Van Diest, Sjoerd G. Elias, Sabine Siesling, E. van der Wall, T. van Dalen, Anne Kuijer |
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| Přispěvatelé: | Health Technology & Services Research |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Oncology
medicine.medical_specialty medicine.medical_treatment Population Decision Making Breast Neoplasms Breast Oncology 03 medical and health sciences 0302 clinical medicine Breast cancer Surgical oncology Internal medicine Antineoplastic Combined Chemotherapy Protocols Journal Article Biomarkers Tumor Medicine Humans Practice Patterns Physicians' education Aged Retrospective Studies education.field_of_study Chemotherapy business.industry Gene Expression Profiling Patient Selection Guideline Odds ratio Middle Aged medicine.disease Prognosis Confidence interval Cancer registry Chemotherapy Adjuvant 030220 oncology & carcinogenesis Practice Guidelines as Topic 030211 gastroenterology & hepatology Surgery Female business Transcriptome Follow-Up Studies |
| Zdroj: | Annals of surgical oncology, 26(11), 3495-3501. Springer Annals of Surgical Oncology Annals of Surgical Oncology, 26(11), 3495. Springer New York |
| ISSN: | 1068-9265 |
| Popis: | Purpose We assessed the recent trends in the administration of adjuvant chemotherapy thereby evaluating the role of the 70-gene signature (70-GS) testing in decision-making in the systemic treatment of patients with lymph node negative (N0) and lymph node positive (N+) breast cancer. Methods Patients with a national guideline directed indication for 70-GS use treated between 2013 and 2016 were selected from the Netherlands Cancer Registry. Time trends in the administration of adjuvant chemotherapy were evaluated within guideline- and age-delineated subgroups. The influence of the 70-GS on chemotherapy use was assessed with logistic regression. Results During the study period, the overall administration of adjuvant chemotherapy decreased from 49 to 23% and 70-GS use increased from 24 to 51%. The 70-GS was not associated with a decreased likelihood for N0 patients to receive chemotherapy (odds ratio [OR] 1.0; 95% confidence interval [CI] 0.86–1.17), as the proportion of N0 patients who received chemotherapy in the absence of 70-GS use decreased during the study period. In patients with N1a disease, 70-GS testing was associated with a decreased likelihood to receive chemotherapy (OR 0.21; 95% CI 0.15–0.29). In patients |
| Databáze: | OpenAIRE |
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