Review
. 2019 Dec;11().
doi: 10.2147/CMAR.S221676.

Decision of Adjuvant Systemic Treatment in HR+ HER2- Early Invasive Breast Cancer: Which Biomarkers Could Help?

Marie Alexandre 1 Aurélie Maran-Gonzalez 2 Marie Viala 1 Nelly Firmin 1 Véronique D'Hondt 1 Marian Gutowski 3 Céline Bourgier 4 William Jacot 1 Séverine Guiu 1 
Affiliations
  • PMID: 31849525
  •     106 References

Abstract

The decision to administer adjuvant chemotherapy in treatment of early invasive breast cancer (EBC) is often complex, particularly for hormone receptor-positive (HR+) diseases, and current guidelines often classify these patients in an intermediate-risk group. Several biomarkers are currently available in this indication, in order to obtain additional and more accurate prognostic information compared to classic clinicopathological characteristics and guide the indication of adjuvant chemotherapy, optimizing the efficacy/toxicity ratio. We conducted a systematic review to evaluate the clinical validity and clinical utility of five biomarkers (uPA/PAI-1, OncotypeDX®, MammaPrint®, PAM50, and EndoPredict®) in HR+/HER2- EBC, whatever the nodal status. A total of 89 studies met the inclusion criteria. Even though data currently available confirm the clinical validity of these biomarkers, there is a lack of data regarding clinical utility for most of them. Prospective studies in well-defined populations are needed to integrate these biomarkers in a decision strategy.

Keywords: adjuvant chemotherapy; biomarkers; breast cancer.

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The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial.
F Fitzal, M Filipits, +9 authors, M Gnant.
Br J Cancer, 2015 Apr 14; 112(8). PMID: 25867274    Free PMC article.
Long-term impact of the 70-gene signature on breast cancer outcome.
C A Drukker, H van Tinteren, +4 authors, L J Van't Veer.
Breast Cancer Res Treat, 2014 Jan 22; 143(3). PMID: 24445566    Free PMC article.
EndoPredict improves the prognostic classification derived from common clinical guidelines in ER-positive, HER2-negative early breast cancer.
P Dubsky, M Filipits, +17 authors, Austrian Breast and Colorectal Cancer Study Group (ABCSG).
Ann Oncol, 2012 Oct 05; 24(3). PMID: 23035151    Free PMC article.
The 70-gene prognosis signature predicts early metastasis in breast cancer patients between 55 and 70 years of age.
S Mook, M K Schmidt, +7 authors, L J van 't Veer.
Ann Oncol, 2009 Oct 15; 21(4). PMID: 19825882
Clinical significance of the 21-gene signature (Oncotype DX) in hormone receptor-positive early stage primary breast cancer in the Japanese population.
Masakazu Toi, Hiroji Iwata, +8 authors, Japan Breast Cancer Research Group-Translational Research Group.
Cancer, 2010 Jun 22; 116(13). PMID: 20564629
The 70-gene prognosis-signature predicts disease outcome in breast cancer patients with 1-3 positive lymph nodes in an independent validation study.
Stella Mook, Marjanka K Schmidt, +10 authors, TRANSBIG Consortium.
Breast Cancer Res Treat, 2008 Jul 29; 116(2). PMID: 18661261
A new molecular predictor of distant recurrence in ER-positive, HER2-negative breast cancer adds independent information to conventional clinical risk factors.
Martin Filipits, Margaretha Rudas, +25 authors, EP Investigators.
Clin Cancer Res, 2011 Aug 03; 17(18). PMID: 21807638
Highly Cited.
Comparison of EndoPredict and EPclin With Oncotype DX Recurrence Score for Prediction of Risk of Distant Recurrence After Endocrine Therapy.
Richard Buus, Ivana Sestak, +7 authors, Mitch Dowsett.
J Natl Cancer Inst, 2016 Jul 13; 108(11). PMID: 27400969    Free PMC article.
Highly Cited.