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|Title: ||IMPACT OF MAMMAPRINT ON THE ROUTINE TREATMENT DECISION MAKING PROCESS IN AN UNSELECTED EARLY BREAST CANCER PATIENT POPULATION IN BELGIUM|
|Authors: ||Cusumano, P. G.|
|Issue Date: ||2010|
|Publisher: ||OXFORD UNIV PRESS|
|Citation: ||ANNALS OF ONCOLOGY, 21. p. 86-87|
|Abstract: ||Background: Multidisciplinary teams nowadays decide on oncological adjuvant treatments by using common clinical and biological criteria. Differences in the quality of IHC analysis and medical board interpretation of prognostic and predictive factors can substantially affect the adjuvant strategy resulting in risks for under- and overtreatment. The main objective of this study is to compare decisions taken when diagnostic gene expression analysis (70-gene MammaPrint assay)(MP) is added prospectively, to the traditional treatment decision making process in an unselected patient. Methods: In 2009, we collected fresh tumour samples during surgery in 162 breast cancer patients. Sufficient RNA for microarray analysis was obtained from 135 patients. MammaPrint low risk (MP LR) profiles were found in 42% MammaPrint high risk (MP HR) profiles in 58% of the patients. Following conventional treatment recommendations, 11 of 57 (19%) MP LR patients received chemotherapy and 34 of 78 (44%) MP HR patients received no chemotherapy. The MP HR patients receiving no chemotherapy (CT) and MP LR patients receiving CT were considered unmatched cases and submitted for second opinion to three independent academic teams initially blinded and subsequently unblinded for the MP. Results: According to the initial recommendation (blinded for MP) of these 3 academic teams, 13 of 34 MP HR patients remained without CT and 9 of 11 MP LR patients would still receive chemotherapy. Subsequently, unblinded for the MammaPrint result, these 3 academic teams changed their recommendation in 6 of 13 MP HR patients. Ultimately, from the 78 patients classified as High risk by MammaPrint, 7 remained without chemotherapy treatment recommendation in this multidisciplinary adjuvant treatment planning(9%). Conclusions: This study demonstrates high variability in the adjuvant strategies between multidisciplinary teams based on traditional patient and tumour related parameters. In our study population, the MammaPrint gene profile would have modified adjuvant treatment recommendation in at least 10% of patients.|
|Notes: ||[Cusumano, P. G.; Jossa, V.] CHC Liege, Breast Unit, Liege, Belgium. [Liebens, F.; Carly, B.] CHU St Pierre, Breast Unit, Brussels, Belgium. [Jerusalem, G.; Lifrange, E.] CHU Liege, Liege, Belgium. [Janssens, J.; Vlasselaer, J.] Univ Hasselt, Hasselt, Belgium.|
|ISI #: ||000283115900258|
|Type: ||Journal Contribution|
|Appears in Collections: ||Research publications|
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