MammaPrint guides treatment decisions in breast Cancer: results of the IMPACt trial

Autor: William Audeh, Varsha Shah, Rubina Qamar, Ellis G. Levine, Gordan Srkalovic, Reshma Mahtani, Sarah Untch, Heather M. Kling, Robert Gabordi, B Mavromatis, Tina Treece, Hatem Soliman, Mohamad Kassar, Jayanthi Srinivasiah
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Cancer Research
medicine.medical_specialty
Genotyping Techniques
Clinical Decision-Making
Population
MEDLINE
Breast Neoplasms
lcsh:RC254-282
Molecular profiling
03 medical and health sciences
0302 clinical medicine
Breast cancer
MammaPrint
Surgical oncology
Internal medicine
Biomarkers
Tumor
Genetics
medicine
Humans
Prospective Studies
Precision Medicine
Stage (cooking)
education
Lymph node
Neoplasm Staging
education.field_of_study
80-GS
medicine.diagnostic_test
business.industry
Middle Aged
Diagnostic test
Clinical utility
medicine.disease
BluePrint
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
030104 developmental biology
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Female
Clinical Competence
Risk assessment
business
70-GS
Research Article
Zdroj: BMC Cancer, Vol 20, Iss 1, Pp 1-13 (2020)
BMC Cancer
ISSN: 1471-2407
0267-0577
Popis: Background Increased usage of genomic risk assessment assays suggests increased reliance on data provided by these assays to guide therapy decisions. The current study aimed to assess the change in treatment decision and physician confidence based on the 70-gene risk of recurrence signature (70-GS, MammaPrint) and the 80-gene molecular subtype signature (80-GS, BluePrint) in early stage breast cancer patients. Methods IMPACt, a prospective, case-only study, enrolled 452 patients between November 2015 and August 2017. The primary objective population included 358 patients with stage I-II, hormone receptor-positive, HER2-negative breast cancer. The recommended treatment plan and physician confidence were captured before and after receiving results for 70-GS and 80-GS. Treatment was started after obtaining results. The distribution of 70-GS High Risk (HR) and Low Risk (LR) patients was evaluated, in addition to the distribution of 80-GS compared to IHC status. Results The 70-GS classified 62.5% (n = 224/358) of patients as LR and 37.5% (n = 134/358) as HR. Treatment decisions were changed for 24.0% (n = 86/358) of patients after receiving 70-GS and 80-GS results. Of the LR patients initially prescribed CT, 71.0% (44/62) had CT removed from their treatment recommendation. Of the HR patients not initially prescribed CT, 65.1% (41/63) had CT added. After receiving 70-GS results, CT was included in 83.6% (n = 112/134) of 70-GS HR patient treatment plans, and 91.5% (n = 205/224) of 70-GS LR patient treatment plans did not include CT. For patients who disagreed with the treatment recommended by their physicians, most (94.1%, n = 16/17) elected not to receive CT when it was recommended. For patients whose physician-recommended treatment plan was discordant with 70-GS results, discordance was significantly associated with age and lymph node status. Conclusions The IMPACt trial showed that treatment plans were 88.5% (n = 317/358) in agreement with 70-GS results, indicating that physicians make treatment decisions in clinical practice based on the 70-GS result. In clinically high risk, 70-GS Low Risk patients, there was a 60.0% reduction in treatment recommendations that include CT. Additionally, physicians reported having greater confidence in treatment decisions for their patients in 72% (n = 258/358) of cases after receiving 70-GS results. Trial registration “Measuring the Impact of MammaPrint on Adjuvant and Neoadjuvant Treatment in Breast Cancer Patients: A Prospective Registry” (NCT02670577) retrospectively registered on Jan 27, 2016.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje