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Gene expression test distinguishes between breast cancer patients at high and low risk of late recurrence
Date:5/2/2013

, of patients who were classified by the test as having low risk, 98.7% had not had a late metastasis between 5 and 10 years of follow-up, compared to 91.5% of those with a high PAM50 ROR score. This was true both for node-positive and node-negative disease.

"It makes a huge difference whether a patient looks at an individual risk of 1.3% or 8.5% between years 5 and 10. This is more than six times as much risk. Such important information may well be implemented into individual treatment decisions," Prof Gnant says.

The researchers conclude that the PAM50 ROR score can successfully be used to differentiate patients with respect to their risk for late metastasis, in addition to established clinical and pathological risk factors.

This ability to predict late metastasis may be used in the future to identify patients with endocrine-responsive breast cancer who need or alternatively who can be spared extended adjuvant therapy, they say.

"We have to admit that at this point we cannot prove definitely that we will improve the outcome in patients we have now identified as high risk by extending their adjuvant therapy, but it appears logical that this may be the case. At least as important, if we can define an individual patient reliably as low risk, we can spare her the burden of unnecessary treatment extension," Prof Gnant says.

Commenting on the results, Dr W Fraser Symmans, Professor and Director of Research Operations, Department of Pathology at the University of Texas M.D. Anderson Cancer Center, USA, said they were important for prognostic testing of early breast cancers and for confidently limiting the duration of endocrine therapy to 5 years for women with low-risk disease.

"In the last 6 months it has become clear that three prognostic tests, including the PAM50 ROR score, have similar prognostic utility that holds for up to 15 years after initial diagnosis. It is particularly exciting for the diagnostic commu
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Contact: Vanessa Pavinato
media@esmo.org
European Society for Medical Oncology
Source:Eurekalert

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