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Microarray provides 3 genomic guides to breast cancer treatment decisions
Date:9/7/2007

sceptible to endocrine therapy. Two had cancers sensitive to both therapies.

Of the 143 patients predicted to have a high risk of recurrence, the analysis predicted 109 had cancer unlikely to respond to endocrine therapy, 64 were predicted to be insensitive to chemotherapy, and 38 were predicted to be unlikely to respond to both therapies.

Ultimately, Pusztai says, the predictors will help guide the decision whether to follow surgery with chemotherapy, endocrine therapy, both, or neither. A planned prospective clinical trial at M. D. Anderson will use these predictors to select treatment options for new patients.

"Let's say a new patient has a needle biopsy performed, and the microarray analysis of the tumor's gene expression predicts she is at low risk of recurrence and also has cancer that is insensitive to both chemo- and endocrine therapies; in this cases the best option is relatively clear; surgery alone," Pusztai explains. "However, it is important to know the sensitivity of the cancer to chemo- or endocrine therapies independent of the risk of recurrence alone. For example, a person even with low risk for cancer recurrence might elect to receive further therapy if her cancer is known to be highly susceptible to treatment."

Similarly, a patient with highly endocrine-sensitive cancer that is resistant to chemotherapy could avoid potentially toxic chemotherapy. Even individuals who are at high risk of recurrence and show genomic signs of low sensitivity to chemo and endocrine therapies could benefit from this knowledge; they might choose to participate in clinical trials with novel drugs.

The researchers' poster also covers genomic analysis of another 40 patients who received paclitaxel/FAC chemotherapy before surgery. Of those, 14 were predicted at low risk or recurrence (were they treated with surgery alone), four of whom (28 percent) had a complete pathologic response - no sign of cancer - supporting the investiga
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Contact: Scott Merville
sdmervil@mdanderson.org
713-792-0661
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert

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