Navigation Links
Genomic test shows promise as chemotherapy response, survival predictor for women with breast cancer

HOUSTON A new genomic test combining multiple signatures a patient's estrogen receptor status, endocrine therapy response, chemotherapy resistance and sensitivity shows promise as a predictor of chemotherapy response and survival benefit in women with invasive breast cancer, according to research led by The University of Texas MD Anderson Cancer Center.

The findings, published in the May 11 issue of JAMA, also may determine those for whom standard therapy alone might not offer enough, and/or for whom an appropriate clinical trial in the adjuvant setting could provide additional benefit.

"The research builds on a decade of collaborative work in developing a clinically meaningful chemotherapy predictor, and, if validated in future studies, could guide therapy for about 80 percent of newly diagnosed women with invasive breast cancer who are candidates for chemotherapy," says W. Fraser Symmans, MD, professor in MD Anderson's Department of Pathology.

"The test helps us understand both resistance and response to chemotherapy more specifically, how sensitivity to endocrine therapy would impact a predictor and how to focus on specific subtypes of breast cancer in this case HER2 negative disease stratified by estrogen receptor (ER) status because we've learned that they are so intrinsically different," Symmans continues.

The multicenter study enrolled 310 Stage II and III newly diagnosed women with invasive breast cancer (discovery cohort). All were Her2 negative and received the chemotherapy regimen of sequential taxane and anthracycline, followed by endocrine therapy, if hormone receptor positive. Gene expression microarrays from the discovery cohort were used to develop different predictive signatures for drug resistance and response. Using the signatures for endocrine therapy response, chemotherapy resistance and sensitivity, in combination with other genomic predictors to chemotherapy response, breast cancer treatment was predicted in an independent cohort of 198 breast cancer patients with similar diagnosis and treatment (independent cohort).

The study's primary endpoint was distant relapse-free survival (DRFS) and absolute risk reduction (ARR) and the median follow up was three years. Excluding women with known endocrine sensitivity, the algorithm had a positive predictive value (PPV) of 56 percent. In the 28 percent who were predicted treatment-sensitive, their three-year DRFS was 92 percent, ARR was18 percent and they had a five-fold reduction of risk of distant relapse.

When analyzed by ER status, treatment sensitivity was predicted in 30 percent of the ER-positive women and in 26 percent of those who were ER-negative. At three year follow up, DRFS and ARR was 97 percent and 11 percent, respectively, in the ER-positive cohort, compared to 83 percent and 26 percent, respectively, in the ER-negative cohort.

"From a therapeutic standpoint, we know that the treatment a patient receives at initial diagnosis offers the greatest chance for cure. At the same time, we have many potential clinical trials with novel therapeutics and targeted agents in breast cancer. Currently, we're still not sure who we are curing with chemotherapy and who also could benefit from these novel therapies," says Lajos Pusztai, M.D., D.Phil, professor in the Department of Breast Medical Oncology and an author on the study.

If validated in future studies, these findings could be used as a treatment gatekeeper, explains Pusztai, guiding women and their physicians by affirming the selection of standard chemotherapy or, for those at greater risk for recurrence, to a potentially therapeutic clinical trial in the adjuvant setting, from which they may gain further clinical benefit.


Contact: Laura Sussman
University of Texas M. D. Anderson Cancer Center

Related medicine news :

1. Genomic signature in post-menopausal women may explain why pregnancy reduces breast cancer risk
2. New genomics research investigates metastatic childhood cancers
3. Promise of genomics research needs a realistic view
4. NHGRI charts course for the next phase of genomics research
5. Tufts University calls for moderate approach to teaching personalized genomic testing
6. Genomic markers may head off thousands of thyroid surgeries
7. Forces for cancer spread: Genomic instability and evolutionary selection
8. Genomic Systems announces moratorium on studying and treating terminal cancer has ended
9. La Jolla Institute to develop San Diegos first center for RNAi genomics research
10. Radiation pharmacogenomics identifies biomarkers that could personalize cancer treatment
11. St. Jude researcher receives grant to focus on cancer pharmacogenomics in children
Post Your Comments:
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... On Friday, ... presented a Bronze Wellness at Work award to iHire in recognition of their exemplary ... part of the 7th annual Maryland Workplace Health & Wellness Symposium at the BWI ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... June 19, ... the dangers associated with chronic pain and the benefits of holistic treatments, Serenity ... who are suffering with Sickle Cell Disease. , Sickle Cell Disease (SCD) is a ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with all ... brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine ... Making in Emergency Medicine conference in Ponte Vedra Beach, FL. The awards honor ... Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , “With this ...
(Date:6/24/2016)... ... June 24, 2016 , ... National recruitment firm Slone Partners ... with extensive sequencing and genomics experience, as Vice President of North American Capital Sales ... be responsible for leading the sales team in the commercialization of the HTG EdgeSeq ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Research and Markets has announced the addition of the ... to their offering. ... World Market for Companion Diagnostics covers the world market for ... report includes the following: , World IVD ... (N. America, EU, ROW), 2015-2020 , World IVD Companion ...
(Date:6/23/2016)... , June 23, 2016  MedSource announced today ... its e-clinical software solution of choice.  This latest ... possible value to their clients by offering a ... preferred relationship establishes nowEDC as the EDC platform ... MedSource,s full-service clients.  "nowEDC has long been a ...
(Date:6/23/2016)... June 23, 2016 Roche (SIX: RO, ROG; ... for its Elecsys BRAHMS PCT (procalcitonin) assay as a ... septic shock. With this clearance, Roche is the first ... integrated solution for sepsis risk assessment and management. ... infection and PCT levels in blood can aid clinicians ...
Breaking Medicine Technology: