Literature DB >> 15867229

Prognostic role of a multigene reverse transcriptase-PCR assay in patients with node-negative breast cancer not receiving adjuvant systemic therapy.

Francisco J Esteva1, Aysegul A Sahin, Massimo Cristofanilli, Kevin Coombes, Sang-Joon Lee, Joffre Baker, Maureen Cronin, Michael Walker, Drew Watson, Steven Shak, Gabriel N Hortobagyi.   

Abstract

PURPOSE: To test the ability of a reverse transcriptase-PCR (RT-PCR) assay, based on gene expression profiles, to accurately determine the risk of recurrence in patients with node-negative breast cancer who did not receive systemic therapy using formalin-fixed, paraffin-embedded tissue. A secondary objective was to determine whether the quantitative RT-PCR data correlated with immunohistochemistry assay data regarding estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status. PATIENTS AND METHODS: We obtained archival paraffin-embedded tissue from patients with invasive breast cancer but no axillary lymph node involvement who had received no adjuvant systemic therapy and been followed for at least 5 years. RNA was extracted from three 10-microm-thick sections. The expression of 16 cancer-related genes and 5 reference genes was quantified using RT-PCR. A gene expression algorithm was used to calculate a recurrence score for each patient. We then assessed the ability of the test to accurately predict distant recurrence-free survival in this population.
RESULTS: We identified 149 eligible patients. Median age at diagnosis was 59 years; mean tumor diameter was 2 cm; and 69% of tumors were estrogen receptor positive. Median follow-up was 18 years. The 5-year disease-free survival rate for the group was 80%. The 21 gene-based recurrence score was not predictive of distant disease recurrence. However, a high concordance between RT-PCR and immunohistochemical assays for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status was noted.
CONCLUSIONS: RT-PCR can be done on paraffin-embedded tissue to validate the large numbers of genes associated with breast cancer recurrence. However, further work needs to be done to develop an assay to identify the likelihood of recurrent disease in patients with node-negative breast cancer who do not receive adjuvant tamoxifen or chemotherapy.

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Year:  2005        PMID: 15867229     DOI: 10.1158/1078-0432.CCR-04-1707

Source DB:  PubMed          Journal:  Clin Cancer Res        ISSN: 1078-0432            Impact factor:   12.531


  47 in total

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2.  Cost Effectiveness of Gene Expression Profile Testing in Community Practice.

Authors:  Young Chandler; Clyde B Schechter; Jinani Jayasekera; Aimee Near; Suzanne C O'Neill; Claudine Isaacs; Charles E Phelps; G Thomas Ray; Tracy A Lieu; Scott Ramsey; Jeanne S Mandelblatt
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5.  Angiogenesis-associated sequence variants relative to breast cancer recurrence and survival.

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6.  Multigene Assays for Classification, Prognosis, and Prediction in Breast Cancer: a Critical Review on the Background and Clinical Utility.

Authors:  P Sinn; S Aulmann; R Wirtz; S Schott; F Marmé; Z Varga; A Lebeau; H Kreipe; A Schneeweiss
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Review 7.  Clinical utility of gene-expression signatures in early stage breast cancer.

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Review 8.  Gene expression profile assays as predictors of distant recurrence-free survival in early-stage breast cancer.

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Journal:  Cancer Invest       Date:  2009-11       Impact factor: 2.176

9.  The epidermal growth factor receptor family in breast cancer.

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10.  Gene expression profiling for guiding adjuvant chemotherapy decisions in women with early breast cancer: an evidence-based and economic analysis.

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Journal:  Ont Health Technol Assess Ser       Date:  2010-12-01
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