Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 28;13(19):4840.
doi: 10.3390/cancers13194840.

Using Breast Cancer Gene Expression Signatures in Clinical Practice: Unsolved Issues, Ongoing Trials and Future Perspectives

Romain Varnier  1 , Christophe Sajous  1 , Solène de Talhouet  1 , Colette Smentek  2 , Julien Péron  1   3 , Benoît You  1   4 , Thibaut Reverdy  1 , Gilles Freyer  1   4
Affiliations
Review

Using Breast Cancer Gene Expression Signatures in Clinical Practice: Unsolved Issues, Ongoing Trials and Future Perspectives

Romain Varnier et al. Cancers (Basel). .

Abstract

The development of gene expression signatures since the early 2000's has offered standardized assays to evaluate the prognosis of early breast cancer. Five signatures are currently commercially available and recommended by several international guidelines to individualize adjuvant chemotherapy decisions in hormone receptors-positive/HER2-negative early breast cancer. However, many questions remain unanswered about their predictive ability, reproducibility and external validity in specific populations. They also represent a new hope to tailor (neo)adjuvant systemic treatment, adjuvant radiation therapy, hormone therapy duration and to identify a subset of patients who might benefit from CDK4/6 inhibitor adjuvant treatment. This review will highlight these particular issues, address the remaining questions and discuss the ongoing and future trials.

Keywords: breast cancer; clinical trials; gene expression signature; genomic assay.

PubMed Disclaimer

Conflict of interest statement

G.F. has received speaker honorarium from Veracyte, Nanostring and Genomic Health, and has received compensation as a board member for Veracyte and Nanostring. All other authors have nothing to disclose.

References

    1. Nicolini A., Ferrari P., Duffy M.J. Prognostic and predictive biomarkers in breast cancer: Past, present and future. Semin. Cancer Biol. 2018;52:56–73. doi: 10.1016/j.semcancer.2017.08.010. - DOI - PubMed
    1. Puppe J., Seifert T., Eichler C., Pilch H., Mallmann P., Malter W. Genomic Signatures in Luminal Breast Cancer. Breast Care. 2020;15:355–365. doi: 10.1159/000509846. - DOI - PMC - PubMed
    1. Varga Z., Sinn P., Seidman A.D. Summary of head-to-head comparisons of patient risk classifications by the 21-gene Recurrence Score® (RS) assay and other genomic assays for early breast cancer. Int. J. Cancer. 2019;145:882–893. doi: 10.1002/ijc.32139. - DOI - PubMed
    1. Bartlett J.M.S., Bayani J., Marshall A., Dunn J.A., Campbell A., Cunningham C., Sobol M.S., Hall P.S., Poole C.J., Cameron D.A., et al. Comparing breast cancer multiparameter tests in the optima prelim trial: No test is more equal than the others. J. Natl. Cancer Inst. 2016;108:djw050. doi: 10.1093/jnci/djw050. - DOI - PMC - PubMed
    1. Sestak I., Buus R., Cuzick J., Dubsky P., Kronenwett R., Denkert C., Ferree S., Sgroi D., Schnabel C., Baehner F.L., et al. Comparison of the performance of 6 prognostic signatures for estrogen receptor–positive breast cancer. JAMA Oncol. 2018;4:545–553. doi: 10.1001/jamaoncol.2017.5524. - DOI - PMC - PubMed