domingo, 4 de febrero de 2018

Multigene Signature Panels and Breast Cancer Therapy: Patterns of Utilization and Impact on Clinical Decision Making. - PubMed - NCBI

2018 Jan 20. pii: S1072-7515(18)30024-3. doi: 10.1016/j.jamcollsurg.2017.12.043. [Epub ahead of print]

Multigene Signature Panels and Breast Cancer Therapy: Patterns of Utilization and Impact on Clinical Decision Making.

Bhutiani N1, Egger ME1, Ajkay N1, Scoggins CR1, Martin RC 2nd1, McMasters KM2.

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Abstract

INTRODUCTION:

A growing body of evidence supports the use of multigene signature panels (MSPs) in predicting recurrence risk in patients with invasive breast cancer. This study aimed to evaluate trends in MSP use over time and the effect of MSPs on administration of postoperative chemotherapy.

METHODS:

The National Cancer Database was queried for all women with invasive breast cancer who underwent resection between 2011 and 2014 and had information regarding performance of an MSP, hormone receptor (HR) status, and receipt of chemotherapy. MSP use over time was evaluated and patterns of use of Oncotype DX (ODX) and MammaPrint (MP) were compared.

RESULTS:

In a total of 476,128 patients, an MSP was obtained in 153,782 (30.2%). MSP use increased over time and was associated with a decreased rate of chemotherapy administration (24.6% MSP vs. 37.2% no MSP, p<0.001). ODX remained the most common MSP used throughout the study period. ODX was used more commonly in stage I disease than MP, while MP was used more commonly in stage II and III disease. MP was more commonly used in HR-negative patients, HER2-positive patients, and patients with positive lymph nodes. Postoperative chemotherapy was administered to a higher proportion of patients assessed with MP than with ODX (41.3% vs. 23.4%, respectively, p<0.001).

CONCLUSIONS:

Use of MSPs among patients with breast cancer has increased over time and is associated with a decreased use of adjuvant chemotherapy. ODX continues to be the most widely-used MSP, though MP use has increased over time. Future studies are warranted to determine the optimal use of these MSPs in risk-assessment and postoperative decision making.