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Breast cancer multi-gene tests compared
Date:5/5/2011

th ER-positive breast cancers. This test is currently undergoing clinical validation.

The researchers assessed the two tests on 119 breast cancer specimens from patients who the researchers classified as being at 'clinically intermediate' risk for recurrence based on several criteria: median tumor size 1.5cm, all estrogen receptor-positive, Her2 negative, lymph-node negative and most grade II.

"In other words, these patients would likely be a challenge in terms of whether they would benefit from chemotherapy or not," Dr Kelly said. "In these situations, multi-gene assays can provide additional independent prognostic information."

The results showed that all patients with high RS according to the OncotypeDX were classified as 'luminal B' or 'basal-like' by the PAM50 classifier, whereas the majority of low RS cases (83%) were "luminal A" type. Half (51%) of the Intermediate RS cancers were re-categorized as low risk 'luminal A' cancers by the PAM50. All 'luminal A' cancers are either Low (70%) or Intermediate (30%) risk by RS, whereas 'luminal B' cancers are comprised of a mixed risk group by RS including 33% that are high risk by OncotypeDX.

"These results indicate that there is reasonably good agreement between the two methods for high and low prognostic risk assignment," Dr Kelly said. "However, intermediate risk groups by one assay often include cases with discordant risk prediction by the other method. When discordant risk results are obtained it is currently unknown which assay will predict outcome more accurately."

"At the present time it is uncertain whether patients with an intermediate OncotypeDx RS benefit from chemotherapy," Dr Kelly added. "It is interesting that PAM50 re-categorized about half of the patients with intermediate RS to the low risk luminal A category which suggests that these patients may not benefit much from adjuvant chemotherapy due to their already very good prognosis and limited chemothera
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Contact: Vanessa Pavinato
media@esmo.org
European Society for Medical Oncology
Source:Eurekalert

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