medigraphic.com
ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2008, Number 3

<< Back Next >>

An Med Asoc Med Hosp ABC 2008; 53 (3)

Multigene expression profiling in the prognosis and treatment of breast carcinoma. A brief comment

Soria CD, Ortiz HC

Language: Spanish
References: 20
Page: 154-158
PDF size: 235.32 Kb.


ABSTRACT

Breast carcinoma is a complex group of distinct biological entities with specific pathologic features and biological behavior. Tumor type, tumor size, tumor grade, margin and nodal status along with estrogen receptors, progesterone receptors and Her2/neu expression are used to determine patient treatment and predict prognosis. Studying gene profiling for invasive breast carcinoma, Perou et al. have classified mammary carcinoma into five subtypes: 1) Her2/neu over expressing, 2) luminal A, 3) luminal B, 4) basal-like and 5) normal-like. These groups may also be identified using immunohistochemistry. The importance of this classification is the difference in clinical outcomes, with Her2/neu over expressing and basal-like, associated with poor prognosis. Recently genome research has provided evidence that the molecular features of individual breast cancer may have important implications for prognosis and therapeutic decisions. A multigene assay has been developed, that predicts recurrence and assesses the benefit from chemotherapy in a subset of patients with breast carcinoma. The 21 gene assay known as Oncotype DX® (Genomic Health) is a clinically validated laboratory test, that predicts the likelihood of breast cancer recurrence in women with newly diagnosed, early stage, (estrogen receptor positive and lymph node negative), invasive breast cancer. Oncotype DX® analyzes a specific set of genes within a tumor to determine a recurrence score that corresponds to a specific likelihood of breast cancer recurrence within 10 years of the initial diagnosis. The test measures the expression of each gene by quantitative RT-PCR using RNA from formalin-fixed, paraffin embedded tissue. Molecular genetic will provide a better understanding of the biology of individual tumors, and this information can be used to more accurately classify them in a clinically relevant manner.


REFERENCES

  1. www.inegi.gob.mx

  2. Piña OS, Ortiz HC. Biomarcadores como factores pronósticos y predictivos en carcinoma de glándula mamaria. Criterios de interpretación por inmunohistoquímica. Patol Rev Latinoam 2006; 44: 45-59.

  3. Perou C, Sorlie T, Eisen M, et al. Molecular portraits of human breast tumours. Nature 2000; 406: 747–52.

  4. Tang P, Wang J, Bourne P. Molecular classifications of breast carcinoma with similar terminology and different definitions: are the same? Hum Pathol 2008; 39: 506-513.

  5. Sorlie T, Perou M, Tibshirani R et al. Gene expression patterns of breast carcinomas distinguishes tumor subclasses with clinical implications. Proc Natl Acad Sci USA 2001; 98: 10869–10874.

  6. Smid M, Wang Y, Zhang Y et al. Subtypes of breast cancer show preferential site of relapse. Cancer Res 2008; 68: 3108-1114.

  7. Fadare O, Tavassoli F. The phenotypic spectrum of basal-like breast cancer: A critical appraisal. Adv Anat Pathol 2007; 14: 358–373.

  8. Da Silva L, Clarke C, Lakhani S. Demystifying basal-like breast carcinomas. J Clin Pathol 2007; 60: 1328–1332.

  9. Banerjee S, Reis J, Ashley S et al. Basal-like breast carcinomas: clinical outcome and response to chemotherapy. J Clin Pathol 2006; 59: 729–735.

  10. Moll R, Franke W, Schiller D et al. The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell 1982; 31: 11–24.

  11. Cronin M, Sangli C, Liu M et al. Analytical validation of the Oncotype DX genomic diagnostic test for recurrence prognosis and therapeutic response prediction in node-negative, estrogen receptor-positive breast cancer. Clin Chem 2007; 53: 1084–1091.

  12. Flanagan M, Dabbs D, Brufsky A, Beriwal S, Bhargava R. Histopathologic variables predict Oncotype DX™ recurrence score. Mod Pathol 2008; 1-7.

  13. Paik S, Shak S, Tang G et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med 2004; 351: 2817-1826.

  14. Paik S, Tang G, Shak S et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol 2006; 24: 3726-3734.

  15. Fang L, Xu X, Zhai Y et al. Integrated gene expression profile predicts prognosis of breast cancer patients. Breast Cancer Res Treat 2008 (Epub ahead of print)

  16. Lyman G, Cosler L, Kuderer N, Hornberger J. Impact of a 21-gene RT-PCR assay on treatment decisions in early-stage breast cancer. Cancer 2007; 109: 1011-1018.

  17. Sparano J, Paik S. Development of the 21-gene assay and its application in clinical practice and clinical trials. J Clin Oncol 2008; 26: 721-728.

  18. Dobbe E, Gurney K, Kiekow S et al. Gene-expression assays: new tools to individualize treatment of early-stage breast cancer. Am J Health Syst Pharm 2008; 65: 23-28.

  19. Marchionni L, Wilson R, Wolff A et al. Systematic review: gene expression profiling assays in early-stage breast cancer. Ann Intern Med 2008; 148: 358-369.

  20. Hornberger J, Cosler L, Lyman G. Economic analysis of targeting chemotherapy using a 21-Gene RT-PCR assay in lymph-node–negative, estrogen-receptor–positive, early-stage breast cancer. Am J Manag Care 2005; 11: 313-324.




2020     |     www.medigraphic.com