On the Road to Precision: Understanding the Biology Driving Genomic Assays
Menée à partir de données portant sur 10 004 patientes atteintes d'un cancer du sein HR+ HER2- de stade précoce et sans envahissement ganglionnaire puis validée à partir de données portant sur 1 098 patientes supplémentaires, cette étude évalue la performance d'un outil, intégrant des données génomiques (expression de 21 gènes) et des données clinicopathologiques, pour établir un pronostic et identifier les patientes pouvant bénéficier d'une chimiothérapie adjuvante
In the last two decades, there have been significant advances in understanding the natural history and underlying biology of hormone receptor positive (HR+) or human epidermal growth factor receptor 2 (HER2)− breast cancer. Historically, risk assessment in this breast cancer subtype relied largely upon standard clinical and pathologic features, particularly tumor size and nodal status. However, with the introduction of genomic assays, such as the Oncotype Dx 21-gene Recurrence Score (RS) (Exact Sciences, Madison, WI) and the 70-gene MammaPrint signature (Agendia, Irvine, CA), the landscape of risk determination was decidedly altered and tumor biology could be meaningfully interrogated for early risk assessment and, importantly, for chemotherapy decision making in node-negative disease.1,2 Accumulating data support the potential utility of these genomic tools in patients with axillary lymph node-positive disease;2-4 including the prospectively conducted RxPONDER trial that demonstrated a differential treatment benefit based on menopausal status in patients with an RS of 0-25 and 1-3 positive lymph nodes at a prespecified interim analysis.
Journal of Clinical Oncology , éditorial en libre accès, 2019