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 .
Chromosome 17 centromere (CEP17) duplication as a predictor of anthracycline response: evidence from the NCIC Clinical Trials Group (NCIC CTG) MA.5 Trial
HER2 gene amplification and topoisomerase IIα gene ( TOP2A ) alteration have been associated with increased benefit from anthracycline compared to non-anthracycline containing adjuvant breast cancer chemotherapy in some but not other studies . Chromosome 17 centromere ( CEP17 ) duplication was measured on TMAs from formalin-fixed paraffin-embedded specimens obtained from 639 of 716 premenopausal women with node positive breast cancer who received cyclophosphamide , epirubicin and fluorouracil ( CEF ) or cyclophosphamide , methotrexate and fluorouracil ( CMF )  in the r and omized controlled mammary 5 ( MA.5 ) adjuvant trial . The prognostic impact of CEP17 duplication and its interactions with treatment were studied for relapse-free survival ( RFS ) and overall survival ( OS ) . Overall , CEP17 duplication was not significantly associated with RFS or OS in multivariate analysis . For patients whose tumours had normal CEP17 copy number there were no apparent benefits for CEF compared to CMF for RFS ( HR 0.98 ; 95 % CI 0.68–1.42 ) or OS ( HR 1.10 ; 95 % CI 0.72–1.69 ) . For patients whose tumours had CEP17 duplication , there was significant benefit for CEF compared to CMF for RFS ( HR 0.54 ; CI 0.33–0.89 ) and a trend towards significance for OS ( HR 0.64 ; CI 0.37–1.09 ) . The adjusted P values for interaction between treatment and CEP17 duplication were 0.09 for RFS and 0.13 for OS . This study suggests that CEP17 duplication has a borderline association with clinical responsiveness to anthracycline containing chemotherapy similar to previous results seen with HER2 amplification and TOP2A alteration in MA.5 . An appropriately powered meta- analysis is required to discriminate the predictive value of these three c and i date markers
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 .