Using Breast Cancer Gene Expression Signatures in Clinical Practice: Unsolved Issues, Ongoing Trials and Future Perspectives
| Autor: | Thibaut Reverdy, Solene De Talhouet, Gilles Freyer, Christophe Sajous, Benoit You, Julien Péron, Romain Varnier, Colette Smentek |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
genomic assay Cancer Research medicine.medical_specialty Adjuvant radiotherapy clinical trials business.industry Adjuvant chemotherapy medicine.medical_treatment Neoplasms. Tumors. Oncology. Including cancer and carcinogens Review medicine.disease External validity Clinical Practice Clinical trial gene expression signature Breast cancer breast cancer Internal medicine medicine Hormone therapy business Adjuvant RC254-282 |
| Zdroj: | Cancers Cancers, Vol 13, Iss 4840, p 4840 (2021) |
| ISSN: | 2072-6694 |
| Popis: | Simple Summary Gene expression signatures were initially developed to take into account tumor biology for adjuvant chemotherapy decision and have become a standard option in hormone receptors-positive/HER2-negative early breast cancer. While recent randomized phase III studies have provided high level evidence to support their use, much more remains to be explored. This prospective review highlights the unsolved issues regarding targeted populations, delineates the best clinical indications and addresses questions that ongoing and future trials will have to meet. Apart from adjuvant chemotherapy indications, we review their potential interest to tailor neoadjuvant systemic treatments, adjuvant radiation therapy, extended adjuvant hormone therapy and CDK4/6 inhibitor adjuvant treatment. Abstract The development of gene expression signatures since the early 2000′s has offered standardized assays to evaluate the prognosis of early breast cancer. Five signatures are currently commercially available and recommended by several international guidelines to individualize adjuvant chemotherapy decisions in hormone receptors-positive/HER2-negative early breast cancer. However, many questions remain unanswered about their predictive ability, reproducibility and external validity in specific populations. They also represent a new hope to tailor (neo)adjuvant systemic treatment, adjuvant radiation therapy, hormone therapy duration and to identify a subset of patients who might benefit from CDK4/6 inhibitor adjuvant treatment. This review will highlight these particular issues, address the remaining questions and discuss the ongoing and future trials. |
| Databáze: | OpenAIRE |
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