title: Potential impact of the 70-gene signature in the choice of adjuvant systemic treatment for ER positive, HER2 negative tumors: a single institution experience.
abstract: OBJECTIVE
  We investigated in a single institution series of 124 women with operable breast cancer whether tumor clinicopathological features could predict the 70-gene signature (Mammaprint, MP) results, and whether MP results could help to make decisions for the use of chemotherapy (CT) in patients (pts) with ER positive breast cancer beyond recommendations of international guidelines.
  
  
  RESULTS
  Among the 68 ER/PgR positive, HER2 negative tumors, Ki-67 ≥ 20% was the only significant predictor of a high risk-MP among standard clinicopathological features. In candidates for endocrine therapy with undetermined benefit from CT according to international guidelines, MP results would have led to different treatment decisions in 13/46 (28%) and in 20/68 (29%) pts according to NCCN and St. Gallen recommendations, respectively.
  
  
  CONCLUSIONS
  Ki-67 independently predicted high risk-MP in ER/PgR positive, HER2 negative tumors. MP results would have led to discordant treatment recommendations in about 30% of cases, generally increasing indication rate for CT. The results of large randomized trials are warranted in order to understand whether we should rely on multigene assays rather than on standard clinicopathological features for treatment decisions.
authors: Division of Oncology and Hematology, Istituto Clinico Humanitas, Via Manzoni 56, Rozzano, 20089 Milano, Italy. rosalba.torrisi@cancercenter.humanitas.it
authors: R
authors: R
authors: Torrisi
authors: C A
authors: CA
authors: Garcia-Etienne
authors: A
authors: A
authors: Losurdo
authors: E
authors: E
authors: Morenghi
authors: L
authors: L
authors: Di Tommaso
authors: W
authors: W
authors: Gatzemeier
authors: A
authors: A
authors: Sagona
authors: B
authors: B
authors: Fernandes
authors: C
authors: C
authors: Rossetti
authors: M
authors: M
authors: Eboli
authors: A
authors: A
authors: Rubino
authors: E
authors: E
authors: Barbieri
authors: C
authors: C
authors: Andreoli
authors: S
authors: S
authors: Orefice
authors: C
authors: C
authors: Gandini
authors: S
authors: S
authors: Rota
authors: M
authors: M
authors: Zuradelli
authors: G
authors: G
authors: Masci
authors: A
authors: A
authors: Santoro
authors: C
authors: C
authors: Tinterri
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D016015:Logistic Models; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human