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 Index Identifies Early-Stage Estrogen Receptor–Positive Breast Cancer Patients at Risk for Early- and Late-Distant Recurrence
Purpose : Residual risk of relapse remains a substantial concern for patients with hormone receptor – positive breast cancer , with approximately half of all disease recurrences occurring after five years of adjuvant antiestrogen therapy . Experimental Design : The objective of this study was to examine the prognostic performance of an optimized model of Breast Cancer Index ( BCI ) , an algorithmic gene expression – based signature , for prediction of early ( 0–5 years ) and late ( > 5 years ) risk of distant recurrence in patients with estrogen receptor – positive ( ER+ ) , lymph node – negative ( LN− ) tumors . The BCI model was vali date d by retrospective analyses of tumor sample s from tamoxifen-treated patients from a r and omized prospect i ve trial ( Stockholm TAM , n = 317 ) and a multi-institutional cohort ( n = 358 ) . Results : Within the Stockholm TAM cohort , BCI risk groups stratified the majority ( ∼65 % ) of patients as low risk with less than 3 % distant recurrence rate for 0 to 5 years and 5 to 10 years . In the multi-institutional cohort , which had larger tumors , 55 % of patients were classified as BCI low risk with less than 5 % distant recurrence rate for 0 to 5 years and 5 to 10 years . For both cohorts , continuous BCI was the most significant prognostic factor beyond st and ard clinicopathologic factors for 0 to 5 years and more than five years . Conclusions : The prognostic sustainability of BCI to assess early- and late-distant recurrence risk at diagnosis has clinical use for decisions of chemotherapy at diagnosis and for decisions for extended adjuvant endocrine therapy beyond five years . Clin Cancer Res ; 19(15 ) ; 4196–205 . © 2013 AACR
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 .