Navigation Links
Genetic information may help predict likelihood of survival following chemotherapy for breast cancer
Date:5/10/2011

Development of a predictive test that included genomic signatures that indicated chemoresistance, chemosensitivity and endocrine sensitivity for women with newly diagnosed breast cancer identified patients with a high probability of survival following chemotherapy, according to a study in the May 11 issue of JAMA.

Identification of patients with high likelihood of survival following a standard chemotherapy regimen (and then endocrine therapy, if estrogen receptor [ER]-positive) would reaffirm a treatment decision regarding the use of chemotherapy. "Conversely, identification of those with significant risk of relapse despite standard chemotherapy could be used to advise participation in an appropriate clinical trial of potentially more effective treatment," according to background information in the article.

Christos Hatzis, Ph.D., of Nuvera Biosciences Inc., Woburn, Mass., and colleagues conducted a study, from June 2000 to March 2010, to develop a predictor of response and survival from chemotherapy for patients with invasive breast cancer. Patients were those with newly diagnosed ERBB2 (HER2 or HER2/neu)-negative breast cancer treated with chemotherapy containing sequential taxane and anthracycline-based regimens (then endocrine therapy if estrogen receptor-positive). Different predictive signatures for resistance and response to preoperative chemotherapy were developed from gene expression microarrays (special type of testing) of newly diagnosed breast cancer (n = 310 patients). Breast cancer treatment sensitivity was predicted using the combination of signatures for sensitivity to endocrine therapy, chemoresistance, and chemosensitivity, with independent validation (198 patients) and comparison with other reported genomic predictors of chemotherapy response.

The researchers found that the chemopredictive test algorithm had a positive predictive value (PPV) of 56 percent for prediction of pathologic response after excluding patients with predicted endocrine sensitivity. In 28 percent of patients predicted to be treatment sensitive, the 3-year distant relapse-free survival (DRFS) was 92 percent, and there was an absolute risk reduction (ARR) of 18 percent. Patients predicted to be treatment sensitive had a 5-fold reduction in the risk of distant relapse. "Overall, there was a significant association between predicted sensitivity to treatment and improved DRFS," the authors write.

Treatment sensitivity was predicted in 37 of 123 patients (30 percent) in the ER-positive phenotypic subgroup and in 19 of 74 (26 percent) in the ER-negative subgroup. In the ER-positive subgroup, these patients had a DRFS of 97 percent and a significant ARR of 11 percent at 3 years of follow-up. Patients with ER-negative cancer predicted to be treatment sensitive had significantly improved 3-year DRFS of 83 percent, an ARR of 26 percent and a positive predictive value for pathologic response of 83 percent.

The researchers note that other genomic predictors showed paradoxically worse survival for patients predicted to be responsive to chemotherapy.

"Any test based on predicted sensitivity, resistance, or both to guide the selection of a standard adjuvant treatment regimen should predict a high probability of survival for patients predicted to be treatment sensitive (negative predictive value, no relapse if predicted to be treatment sensitive) and a clinically meaningful survival difference between patients predicted to be treatment sensitive and insensitive (ARR) as well as improve on predictions using existing clinical-pathological information. The performance of our predictive test meets these criteria in an independent validation cohort," the authors write.

The researchers add that a predictive test with this performance could potentially assist medical decision-making as it could identify patients with stage II-III, ER-positive and ERBB2-negative breast cancer with excellent 3-year and 5-year DRFS (97 percent) following a standard adjuvant treatment.

The authors conclude that it is "imperative to continue to evaluate the predictive accuracy of this test in additional validation studies."


'/>"/>

Contact: Laura Sussman
lsussman@mdanderson.org
713-745-2457
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Genetic defects hold clues to risk for sudden cardiac death
2. New guidelines for cardiovascular genetic testing
3. Epigenetic study reveals new insights into breast cancer
4. Mayo Clinic finds new genetic cause of neurodegeneration
5. New class of cancer drugs could work in colon cancers with genetic mutation, U-M study finds
6. Liver-cell transplants show promise in reversing genetic disease affecting liver and lungs
7. Hope for children with rare genetic defect
8. Parents Want Genetic Testing for Kids: Study
9. Intellectual disability is frequently caused by non-hereditary genetic problems
10. Study: Parents likely to embrace predictive genetic testing for their children if offered
11. MIT biologists pinpoint a genetic change that helps tumors move to other parts of the body
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/31/2016)... ... May 31, 2016 , ... Secura Consultants ... Louis, Missouri from July 21-23 at the Spazio Westport. The conference is a ... Group financial advisers who work primarily with physicians and professionals in the medical ...
(Date:5/31/2016)... ... 31, 2016 , ... "ProDrop 3D Abstract will spark new innovative ideas for ... Austin - CEO of Pixel Film Studios. , Create an abstract backdrop animation ... ability to generate and manipulate three-dimensional shapes with ease all within Final Cut Pro ...
(Date:5/31/2016)... (PRWEB) , ... May 31, 2016 , ... RF Safe's ... provide the best accessories to avoid excessive Smartphone radiation implicated in the most recent ... released on the bioRxiv preprint server on May 26th (PDF) by the ...
(Date:5/31/2016)... ... May 31, 2016 , ... ... characteristics and the physical and behavioral worlds in which they live, functions ... medicine, diagnosing an individual’s disease depends on accurately assessing his or her ...
(Date:5/31/2016)... ... 2016 , ... Presence Technology , a multi-channel provider ... Gartner, Inc. in the Contact Center Infrastructure Magic Quadrant (*). , Gartner’s May ... of which include: Computer-telephony integration (CTI)/Web services interfaces, Tools for integration with ...
Breaking Medicine News(10 mins):
(Date:5/31/2016)... May 31, 2016 The global ... progressing at a CAGR of 10.6% within a forecast ... at US$0.46 bn in 2013. Owing to favorable factors ... reach US$0.88 bn by the end of this forecast ... the market,s holistic representation in a research report published ...
(Date:5/31/2016)... , May 31, 2016 CollPlant Ltd. (TASE: ... rhCollagen technology for tissue repair products - announces that ... Israel,s Ministry of Economy, for ... project for 2016. The Chief Scientist,s grant amount to NIS ... which totaled NIS 4.7 million.  The development ...
(Date:5/30/2016)... 2016 According to ... Market by Technology (Single-factor (Fingerprint, Face, Iris, ... (Workforce Management), End User (Hospitals, Healthcare Institutions) ... MarketsandMarkets, the market is projected to reach ... 1,182.6 Million by 2016, at a CAGR ...
Breaking Medicine Technology: