Incorporating genetic information known as gene expression signatures with clinical and other risk factors for breast cancer may help refine estimates of relapse-free survival and predicted response to chemotherapy, according to a study in the April 2 issue of JAMA.
The advent of genomic technology for the analysis of human tumor samples has now added an additional source of information to aid prognosis and clinical decisions. In particular, the development of genomic profiles that accurately assess risk of recurrence offers the hope that this information will more precisely define clinical outcomes in breast cancer. The dimension and complexity of such data provide an opportunity to uncover clinically valid trends that can distinguish subtle phenotypes [physical manifestations] in ways that traditional methods cannot, the authors write. Few studies have examined the value in integrating genomic information with the traditional clinical risk factors to provide a more detailed assessment of clinical risk and an improved prediction of response to therapy.
Chaitanya R. Acharya, M.S., of the Duke Institute for Genome Sciences and Policy, Duke University, Durham, N.C., and colleagues conducted a study to determine the value in incorporating genomic information with clinical and pathological risk factors to refine prognosis and to improve therapeutic strategies for early stage breast cancer. The study included patients with early stage breast cancer who were candidates for supplemental chemotherapy; 964 breast tumor samples were used. All patients were assigned relapse risk scores based on their respective clinicopathological features. Genetic testing was performed and gene expression signatures (characteristic profiles) were applied to these samples to obtain patterns of deregulation that correspond with relapse risk scores to refine prognosis with the clinicopathological prognostic model alone. Predictors of chemotherapeutic response were also ap
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