Fabrice Andre1, Nofisat Ismaila2, Kimberly H Allison3, William E Barlow4, Deborah E Collyar5, Senthil Damodaran6, N Lynn Henry7, Komal Jhaveri8,9, Kevin Kalinsky10, Nicole M Kuderer11, Anya Litvak12, Erica L Mayer13, Lajos Pusztai14, Rachel Raab15, Antonio C Wolff16, Vered Stearns16. 1. Institute Gustave Roussy, Paris, France. 2. American Society of Clinical Oncology, Alexandria, VA. 3. Stanford University Medical Center, Stanford, CA. 4. Cancer Research and Biostatistics, Seattle, WA. 5. Patient Advocates in Research (PAIR), Danville, CA. 6. MD Anderson Cancer Center, Houston, TX. 7. University of Michigan Rogel Cancer Center, Ann Arbor, MI. 8. Memorial Sloan Kettering Cancer Center, New York, NY. 9. Weill Cornell Medical College, New York, NY. 10. Winship Cancer Institute at Emory University, Atlanta, GA. 11. Advanced Cancer Research Group, Kirkland, WA. 12. Cancer Center at Saint Barnabas Medical Center, Livingston, NJ. 13. Dana-Farber Cancer Institute, Boston, MA. 14. Yale Cancer Center, New Haven, CT. 15. Messino Cancer Centers-A Division of American Oncology Partners, Asheville, NC. 16. Johns Hopkins University, Baltimore, MD.
Abstract
PURPOSE: To update recommendations on appropriate use of breast cancer biomarker assay results to guide adjuvant endocrine and chemotherapy decisions in early-stage breast cancer. METHODS: An updated literature search identified randomized clinical trials and prospective-retrospective studies published from January 2016 to October 2021. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert Panel members used informal consensus to develop evidence-based recommendations. RESULTS: The search identified 24 studies informing the evidence base. RECOMMENDATIONS: Clinicians may use Oncotype DX, MammaPrint, Breast Cancer Index (BCI), and EndoPredict to guide adjuvant endocrine and chemotherapy in patients who are postmenopausal or age > 50 years with early-stage estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative (ER+ and HER2-) breast cancer that is node-negative or with 1-3 positive nodes. Prosigna and BCI may be used in postmenopausal patients with node-negative ER+ and HER2- breast cancer. In premenopausal patients, clinicians may use Oncotype in patients with node-negative ER+ and HER2- breast cancer. Current data suggest that premenopausal patients with 1-3 positive nodes benefit from chemotherapy regardless of genomic assay result. There are no data on use of genomic tests to guide adjuvant chemotherapy in patients with ≥ 4 positive nodes. Ki67 combined with other parameters or immunohistochemistry 4 score may be used in postmenopausal patients without access to genomic tests to guide adjuvant therapy decisions. BCI may be offered to patients with 0-3 positive nodes who received 5 years of endocrine therapy without evidence of recurrence to guide decisions about extended endocrine therapy. None of the assays are recommended for treatment guidance in individuals with HER2-positive or triple-negative breast cancer. Treatment decisions should also consider disease stage, comorbidities, and patient preferences.Additional information is available at www.asco.org/breast-cancer-guidelines.
PURPOSE: To update recommendations on appropriate use of breast cancer biomarker assay results to guide adjuvant endocrine and chemotherapy decisions in early-stage breast cancer. METHODS: An updated literature search identified randomized clinical trials and prospective-retrospective studies published from January 2016 to October 2021. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert Panel members used informal consensus to develop evidence-based recommendations. RESULTS: The search identified 24 studies informing the evidence base. RECOMMENDATIONS: Clinicians may use Oncotype DX, MammaPrint, Breast Cancer Index (BCI), and EndoPredict to guide adjuvant endocrine and chemotherapy in patients who are postmenopausal or age > 50 years with early-stage estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative (ER+ and HER2-) breast cancer that is node-negative or with 1-3 positive nodes. Prosigna and BCI may be used in postmenopausal patients with node-negative ER+ and HER2- breast cancer. In premenopausal patients, clinicians may use Oncotype in patients with node-negative ER+ and HER2- breast cancer. Current data suggest that premenopausal patients with 1-3 positive nodes benefit from chemotherapy regardless of genomic assay result. There are no data on use of genomic tests to guide adjuvant chemotherapy in patients with ≥ 4 positive nodes. Ki67 combined with other parameters or immunohistochemistry 4 score may be used in postmenopausal patients without access to genomic tests to guide adjuvant therapy decisions. BCI may be offered to patients with 0-3 positive nodes who received 5 years of endocrine therapy without evidence of recurrence to guide decisions about extended endocrine therapy. None of the assays are recommended for treatment guidance in individuals with HER2-positive or triple-negative breast cancer. Treatment decisions should also consider disease stage, comorbidities, and patient preferences.Additional information is available at www.asco.org/breast-cancer-guidelines.
Authors: Rima Patel; Malin Hovstadius; Melanie W Kier; Erin L Moshier; Brittney S Zimmerman; Krystal Cascetta; Shabnam Jaffer; Joseph A Sparano; Amy Tiersten Journal: Cancer Date: 2022-08-10 Impact factor: 6.921
Authors: C F Singer; S W Jahn; M Rudas; Z Bago-Horvath; F Fitzal; L Abete; F Moinfar; M Gnant; M Filipits Journal: Breast Date: 2022-05-19 Impact factor: 4.254