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Vol 5, No 6 (2009)
Review paper
Published online: 2010-03-01
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Gene signature as a prognostic factor in breast cancer

Renata Duchnowska
Onkol. Prak. Klin 2009;5(6):237-243.

open access

Vol 5, No 6 (2009)
REVIEW ARTICLES
Published online: 2010-03-01

Abstract

Within the last years a concept of personalized medicine including individual treatment selection has appeared in oncology. This approach is hoped to increase treatment efficacy and decrease its toxicity. Most interest in this area attracts the development of molecular signatures (molecular profiles) with prognostic and predictive value. In this area, the most extensively studied malignancy is breast cancer, and the investigations have been focused on selection of low-risk groups of patients in whom postoperative chemotherapy may be avoided. The available data indicate that molecular profiles may carry stronger prognostic value than currently used clinical and pathological factors. Already now, the guidelines of St. Gallen conference, American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) allow applying molecular profiles to predict prognosis in patients with ambiguous indications to adjuvant chemotherapy. However, due to retrospective nature of the studies to date and small series of patients, the real value of these assays is uncertain and warrants validation in large prospective studies.

Abstract

Within the last years a concept of personalized medicine including individual treatment selection has appeared in oncology. This approach is hoped to increase treatment efficacy and decrease its toxicity. Most interest in this area attracts the development of molecular signatures (molecular profiles) with prognostic and predictive value. In this area, the most extensively studied malignancy is breast cancer, and the investigations have been focused on selection of low-risk groups of patients in whom postoperative chemotherapy may be avoided. The available data indicate that molecular profiles may carry stronger prognostic value than currently used clinical and pathological factors. Already now, the guidelines of St. Gallen conference, American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) allow applying molecular profiles to predict prognosis in patients with ambiguous indications to adjuvant chemotherapy. However, due to retrospective nature of the studies to date and small series of patients, the real value of these assays is uncertain and warrants validation in large prospective studies.
Get Citation

Keywords

breast cancer; molecular profile; molecular signature; DNA microarrays; RT-PCR method; prognostic factors

About this article
Title

Gene signature as a prognostic factor in breast cancer

Journal

Oncology in Clinical Practice

Issue

Vol 5, No 6 (2009)

Article type

Review paper

Pages

237-243

Published online

2010-03-01

Bibliographic record

Onkol. Prak. Klin 2009;5(6):237-243.

Keywords

breast cancer
molecular profile
molecular signature
DNA microarrays
RT-PCR method
prognostic factors

Authors

Renata Duchnowska

References (38)
  1. Goldhirsch A, Wood WC, Gelber RD, et al. 10th St. Gallen conference. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol. 2007; 18(7): 1133–1144.
  2. Dowsett M, Goldhirsch A, Hayes DF, et al. International Web-based consultation on priorities for translational breast cancer research. Breast Cancer Res. 2007; 9(6): R81.
  3. Perou CM, Sørlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature. 2000; 406(6797): 747–752.
  4. Sørlie T, Perou CM, Tibshirani R, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A. 2001; 98(19): 10869–10874.
  5. Rakha EA, El-Sayed ME, Green AR, et al. Biologic and clinical characteristics of breast cancer with single hormone receptor positive phenotype. J Clin Oncol. 2007; 25(30): 4772–4778.
  6. Sorlie T, Tibshirani R, Parker J, et al. Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci U S A. 2003; 100(14): 8418–8423.
  7. Sotiriou C, Neo SY, McShane LM, et al. Breast cancer classification and prognosis based on gene expression profiles from a population-based study. Proc Natl Acad Sci U S A. 2003; 100(18): 10393–10398.
  8. Liu S, Ginestier C, Charafe-Jauffret E, et al. BRCA1 regulates human mammary stem/progenitor cell fate. Proc Natl Acad Sci U S A. 2008; 105(5): 1680–1685.
  9. Kreike B, van Kouwenhove M, Horlings H, et al. Gene expression profiling and histopathological characterization of triple-negative/basal-like breast carcinomas. Breast Cancer Res. 2007; 9(5): R65.
  10. Loi S, Haibe-Kains B, Desmedt C, et al. Definition of clinically distinct molecular subtypes in estrogen receptor-positive breast carcinomas through genomic grade. J Clin Oncol. 2007; 25(10): 1239–1246.
  11. Sotiriou C, Wirapati P, Loi S, et al. Gene expression profiling in breast cancer: understanding the molecular basis of histologic grade to improve prognosis. J Natl Cancer Inst. 2006; 98(4): 262–272.
  12. van 't Veer LJ, Dai H, van de Vijver MJ, et al. Gene expression profiling predicts clinical outcome of breast cancer. Nature. 2002; 415(6871): 530–536.
  13. van de Vijver MJ, He YD, van't Veer LJ, et al. A gene-expression signature as a predictor of survival in breast cancer. N Engl J Med. 2002; 347(25): 1999–2009.
  14. Mook S, Schmidt MK, Weigelt B, et al. The 70-gene prognosis signature predicts early metastasis in breast cancer patients between 55 and 70 years of age. Annals of Oncology. 2009; 21(4): 717–722.
  15. Espinosa E, Vara JA, Redondo A, et al. Breast cancer prognosis determined by gene expression profiling: a quantitative reverse transcriptase polymerase chain reaction study. J Clin Oncol. 2005; 23(29): 7278–7285.
  16. Buyse M, Loi S, van't Veer L, et al. TRANSBIG Consortium. Validation and clinical utility of a 70-gene prognostic signature for women with node-negative breast cancer. J Natl Cancer Inst. 2006; 98(17): 1183–1192.
  17. Wang Y, Klijn JGM, Zhang Yi, et al. Gene-expression profiles to predict distant metastasis of lymph-node-negative primary breast cancer. Lancet. 2005; 365(9460): 671–679.
  18. Foekens JA, Atkins D, Zhang Yi, et al. Multicenter validation of a gene expression-based prognostic signature in lymph node-negative primary breast cancer. J Clin Oncol. 2006; 24(11): 1665–1671.
  19. Desmedt C, Piette F, Loi S, et al. TRANSBIG Consortium. Strong time dependence of the 76-gene prognostic signature for node-negative breast cancer patients in the TRANSBIG multicenter independent validation series. Clin Cancer Res. 2007; 13(11): 3207–3214.
  20. Chang HY, Nuyten DSA, Sneddon JB, et al. Robustness, scalability, and integration of a wound-response gene expression signature in predicting breast cancer survival. Proc Natl Acad Sci U S A. 2005; 102(10): 3738–3743.
  21. Haibe-Kains B, Desmedt C, Piette F, et al. Comparison of prognostic gene expression signatures for breast cancer. BMC Genomics. 2008; 9: 394.
  22. Paik S, Shak S, Tang G, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004; 351(27): 2817–2826.
  23. Paik S, Tang G, Shak S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006; 24(23): 3726–3734.
  24. Cobleigh MA, Tabesh B, Bitterman P, et al. Tumor gene expression and prognosis in breast cancer patients with 10 or more positive lymph nodes. Clin Cancer Res. 2005; 11(24 Pt 1): 8623–8631.
  25. Esteva FJ, Sahin AA, Cristofanilli M, et al. Prognostic role of a multigene reverse transcriptase-PCR assay in patients with node-negative breast cancer not receiving adjuvant systemic therapy. Clin Cancer Res. 2005; 11(9): 3315–3319.
  26. Albain K, Barlow W, Shak S, et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal, node-positive, ER-positive breast cancer (S8814, INT0100). . Breast Cancer Res. Treat. 2007; 106(S10): abstrakt.
  27. Goldstein LJ, Gray R, Badve S, et al. Prognostic utility of the 21-gene assay in hormone receptor-positive operable breast cancer compared with classical clinicopathologic features. J Clin Oncol. 2008; 26(25): 4063–4071.
  28. Gianni L, Zambetti M, Clark K, et al. Gene expression profiles in paraffin-embedded core biopsy tissue predict response to chemotherapy in women with locally advanced breast cancer. J Clin Oncol. 2005; 23(29): 7265–7277.
  29. Ma XJ, Salunga R, Dahiya S, et al. A five-gene molecular grade index and HOXB13:IL17BR are complementary prognostic factors in early stage breast cancer. Clin Cancer Res. 2008; 14(9): 2601–2608.
  30. Ma XJ, Wang Z, Ryan PD, et al. A two-gene expression ratio predicts clinical outcome in breast cancer patients treated with tamoxifen. Cancer Cell. 2004; 5(6): 607–616.
  31. Cardoso F, Van't Veer L, Rutgers E, et al. Clinical application of the 70-gene profile: the MINDACT trial. J Clin Oncol. 2008; 26(5): 729–735.
  32. Sparano JA, Paik S. Development of the 21-gene assay and its application in clinical practice and clinical trials. J Clin Oncol. 2008; 26(5): 721–728.
  33. Goldhirsch A, Ingle JN, Gelber RD, et al. Panel members. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol. 2009; 20(8): 1319–1329.
  34. NCCN. Practice guidelines in oncology. www.nccn.org (01.2008).
  35. Mumby PB, Lo SS, Norton J, et al. Prospective multicenter study of the impact of the 21-gene recurrence score assay on patient satisfaction, anxiety and decisional conflict for adjuvant breast cancer treatment selection. . Breast Cancer Res. Treat. 2007; 106(S73): abstrakt.
  36. Liang H, Burfsky AM, Lembersky BB, et al. A retrospective analysis of the impact of OncotypeDX low recurrence score results on treatment decisions in a single academic breast cancer center. . Breast Cancer Res. Treat. 2007; 106: S105 (abstrakt).
  37. Oratz R, Paul D, Cohn AL, et al. Impact of a commercial reference laboratory test recurrence score on decision making in early-stage breast cancer. J Oncol Pract. 2007; 3(4): 182–186.
  38. Jänicke F, Prechtl A, Thomssen C, et al. German N0 Study Group. Randomized adjuvant chemotherapy trial in high-risk, lymph node-negative breast cancer patients identified by urokinase-type plasminogen activator and plasminogen activator inhibitor type 1. J Natl Cancer Inst. 2001; 93(12): 913–920.

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