Gene expression profiling to guide selection of adjuvant therapy in breast cancer

Breast cancer is in Sweden the most common form of cancer in women and one of the most frequent causes of death in middle-aged women. Molecular genetic tests studying the expression of genes associated with example given metastasizing (spreading of the cancer to other body parts) could help in refining the risk assessment of tumours before decision of adjuvant therapy after surgery. Histopathologic examination is in Sweden routine to guide selection of adjuvant therapy and gene expression profiling is only performed on a research basis.

Question

What is the current state of scientific knowledge regarding gene expression profiling to guide selection of adjuvant therapy in breast cancer?

Identified literature

  1. Wang SY, Dang W, Richman I, Mougalian SS, Evans SB, Gross CP. Cost-Effectiveness Analyses of the 21-Gene Assay in Breast Cancer: Systematic Review and Critical Appraisal. J Clin Oncol 2018:Jco2017765941.
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  3. Scope A, Essat M, Pandor A, Rafia R, Ward SE, Wyld L, et al. Gene expression profiling and expanded immunohistochemistry tests to guide selection of chemotherapy regimens in breast cancer management: a systematic review. Int J Technol Assess Health Care 2017;33:32-45.
  4. Hyams DM, Schuur E, Angel Aristizabal J, Bargallo Rocha JE, Cabello C, Elizalde R, et al. Selecting postoperative adjuvant systemic therapy for early stage breast cancer: A critical assessment of commercially available gene expression assays. Journal of Surgical Oncology 2017;115:647-662.
  5. Chang MC, Souter LH, Kamel-Reid S, Rutherford M, Bedard P, Trudeau M, et al. Clinical utility of multigene profiling assays in early-stage breast cancer. Curr Oncol 2017;24:e403-e422.
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  7. Added value of using the gene expression signature test MammaPrint® for adjuvant chemotherapy decision-making in early breast cancer. European Network for Health Technology Assessment 2018. EUnetHTA Joint Action 3 WP4. Project ID: OTCA04.
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  11. Augustovski F, Soto N, Caporale J, Gonzalez L, Gibbons L, Ciapponi A. Decision-making impact on adjuvant chemotherapy allocation in early node-negative breast cancer with a 21-gene assay: systematic review and meta-analysis. Breast Cancer Res Treat 2015;152:611-25.
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  18. Hornberger J, Alvarado MD, Rebecca C, Gutierrez HR, Yu TM, Gradishar WJ. Clinical validity/utility, change in practice patterns, and economic implications of risk stratifiers to predict outcomes for early-stage breast cancer: a systematic review. J Natl Cancer Inst 2012;104:1068-79.
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  21. Marchionni L, Wilson RF, Wolff AC, Marinopoulos S, Parmigiani G, Bass EB, et al. Systematic review: gene expression profiling assays in early-stage breast cancer. Ann Intern Med 2008;148:358-69.
  22. San ML, Vlayen J, Laet C. Gene expression profiling and immunohistochemistry tests for personalised management of adjuvant chemotherapy decisions in early breast cancer – a Rapid Assessment. Health Technology Assessment (HTA) Brussels: Belgian Health Care Knowledge Centre (KCE) 2015.
  23. Meleth S, Reeder-Hayes K, Ashok M, Clark R, Funkhouser W, Wines R, et al. AHRQ Technology Assessments. In: Technology Assessment of Molecular Pathology Testing for the Estimation of Prognosis for Common Cancers. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014.
  24. Cadth. Oncotype DX in women and men with ER-positive HER2-negative early stage breast cancer Who are lymph node-positive: a review of clinical effectiveness and guidelines (Structured abstract). Health Technology Assessment Database 2014.
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  28. Marchionni L, Wilson RF, Marinopoulos SS, Wolff AC, Parmigiani G, Bass EB, et al. Impact of gene expression profiling tests on breast cancer outcomes (Provisional abstract). Database of Abstracts of Reviews of Effects 2008:218.
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Literature search

Literature search gene expression.pdf

SBU Enquiry Service consists of systematic literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed. The quality of the studies identified is not systematically reviewed.

Published: 6/21/2018
Contact SBU: registrator@sbu.se
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