RECOMMENDATIONS In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2 , the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX , EndoPredict , PAM50 , Breast Cancer Index , and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer .
No biomarker except for estrogen receptor , progesterone receptor , and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens .
PURPOSE To provide recommendations on appropriate use of breast tumor biomarker assay results to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer .
Breast cancer molecular subclassification and estrogen receptor expression to predict efficacy of adjuvant anthracyclines-based chemotherapy: a biomarker study from two randomized trials.
BACKGROUND The purpose of this study was to determine the predictive value of breast cancer molecular subclassification regarding the benefit of adjuvant anthracycline-based chemotherapy . PATIENTS AND METHODS Tumor sample s from 823 patients included in two r and omized trials that compared an anthracycline-based chemotherapy with no treatment  were used to construct a tissue array . Estrogen receptor ( ER ) , Her2 , epidermal growth factor receptor , cytokeratine 5/6 expressions were determined by immunohistochemistry ( IHC ) . The potential predictive factors of treatment effect on disease-free survival ( DFS ) were assessed by interaction tests and multivariate analysis . RESULTS Sixty-four ( 8 % ) , 98 ( 12 % ) , 109 ( 14 % ) and 527 ( 66 % ) patients presented a Her2+/ER- , basal-like , Her2-/ER-/nonbasal and luminal-like breast cancer . ER expression , when assessed by IHC , was an independent predictive factor for the benefit of chemotherapy on DFS ( test for interaction , P = 0.0015 ) . The molecular subclassification significantly predicted the efficacy of chemotherapy ( test for interaction , P = 0.01 ) , but had no significant added value ( P = 0.32 ) as compared to the ER by treatment interaction . Adjuvant chemotherapy was associated with an adjusted hazard ratio for relapse or death of 0.42 [ 95 % confidence interval ( CI ) : 0.17 - 1.05 ] , 0.54 ( 95 % CI : 0.27 - 1.08 ) , 0.35 ( 95 % CI : 0.18 - 0.68 ) , 1.07 ( 95 % CI : 0.81 - 1.41 ) for patients with Her2+/ER- , basal-like , Her2-/ER-/nonbasal and luminal-like tumors , respectively . CONCLUSION The breast cancer molecular subclassification was predictive for chemotherapy efficacy in adjuvant setting , but did not provide significant additional information to ER
RECOMMENDATIONS In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2 , the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX , EndoPredict , PAM50 , Breast Cancer Index , and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer .
No biomarker except for estrogen receptor , progesterone receptor , and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens .
PURPOSE To provide recommendations on appropriate use of breast tumor biomarker assay results to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer .