Strong impact of MammaPrint and BluePrint on treatment decisions in luminal early breast cancer: results of the WSG-PRIMe study.
In: Breast cancer research and treatment, Jg. 175 (2019-06-01), Heft 2, S. 389-399
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academicJournal
Zugriff:
Purpose: The WSG-PRIMe Study prospectively evaluated the impact of the 70-gene signature MammaPrint® (MP) and the 80-gene molecular subtyping assay BluePrint® on clinical therapy decisions in luminal early breast cancer.
Methods: 452 hormone receptor (HR)-positive and HER2-negative patients were recruited (N0, N1). Physicians provided initial therapy recommendations based on clinicopathological factors. After prospective risk classification by MammaPrint/BluePrint was revealed, post-test treatment recommendations and actual treatment were recorded. Decisional Conflict and anxiety were measured by questionnaires.
Results: Post-test switch (in chemotherapy (CT) recommendation) occurred in 29.1% of cases. Overall, physician adherence to MP risk assessment was 92.3% for low-risk and 94.3% for high-risk MP scores. Adherence was remarkably high in "discordant" groups: 74.7% of physicians initially recommending CT switched to CT omission following low-risk MP scores; conversely, 88.9% of physicians initially recommending CT omission switched to CT recommendations following high-risk MP scores. Most patients (99.2%) recommended to forgo CT post-test and 21.3% of patients with post-test CT recommendations did not undergo CT; among MP low-risk patients with pre-test and post-test CT recommendations, 40% did not actually undergo CT. Luminal subtype assessment by BluePrint was discordant with IHC assessment in 34% of patients. Patients' State Anxiety scores improved significantly overall, particularly in MP low-risk patients. Trait Anxiety scores increased slightly in MP high risk and decreased slightly in MP low-risk patients.
Conclusions: MammaPrint and BluePrint test results strongly impacted physicians' therapy decisions in luminal EBC with up to three involved lymph nodes. The high adherence to genetically determined risk assessment represents a key prerequisite for achieving a personalized cost-effective approach to disease management of early breast cancer.
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Strong impact of MammaPrint and BluePrint on treatment decisions in luminal early breast cancer: results of the WSG-PRIMe study.
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Autor/in / Beteiligte Person: | Wuerstlein, R ; Kates, R ; Gluz, O ; Grischke, EM ; Schem, C ; Thill, M ; Hasmueller, S ; Köhler, A ; Otremba, B ; Griesinger, F ; Schindlbeck, C ; Trojan, A ; Otto, F ; Knauer, M ; Pusch, R ; Harbeck, N |
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Zeitschrift: | Breast cancer research and treatment, Jg. 175 (2019-06-01), Heft 2, S. 389-399 |
Veröffentlichung: | Dordrecht : Kluwer Academic ; <i>Original Publication</i>: The Hague ; Boston : M. Nijhoff, c1981-, 2019 |
Medientyp: | academicJournal |
ISSN: | 1573-7217 (electronic) |
DOI: | 10.1007/s10549-018-05075-x |
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