NEW YORK (Reuters Health) - US researchers have developed a multigene assay that can predict distant recurrence of tamoxifen-treated, node-negative breast cancer, according to findings from a new study. The authors of a related editorial are hopeful that this assay will promote individualized care for breast cancer.
The report and the editorial will appear in the December 30th issue of The New England Journal of Medicine, but were released early to coincide with a presentation being made by the researchers at the San Antonio Breast Cancer Symposium.
In the study, Dr. Soonmyung Paik, from the National Surgical Adjuvant Breast and Bowel Project in Pittsburgh, and colleagues used RT-PCR to analyze the expression of 21 genes in tumor specimens obtained from 668 breast cancer patients. The genes, which included 16 cancer-related and 5 reference genes, were selected on the basis of their ability to predict cancer recurrence in earlier studies.
Based on the gene expression profile, the women were divided into groups with a low, intermediate or high risk of recurrence. In addition, the profile was used to calculate a recurrence score for each woman.
The gene expression profile did, in fact, predict the risk of recurrence, the authors note. The rate of distant recurrence at 10 years ranged from 6.8% for the low-risk group to 30.5% for the high-risk group (p < 0.001). About half the patients were classified as low-risk with the remainder being divided between the high- and intermediate-risk groups.
The recurrence score was a strong predictor of recurrence that provided information independent of age and tumor size (p < 0.001), the researchers note.
In a related editorial, Dr. Robert C. Bast and Dr. Gabriel N. Hortobagyi, from the M. D. Anderson Cancer Center in Houston, comment that “this is an exciting work in progress. Additional validation in independent laboratories with the use of biopsy specimens from other clinical trials should provide complementary information to help determine the role that the recurrence score might play in the care of patients with primary breast cancer.”
Source: N Engl J Med 2004;351:2817-2826,2865-2866. [ Google search on this article ]
MeSH Headings:Breast Neoplasms: Congresses: Health Care Economics and Organizations: Neoplasms: Neoplasms by Site: Organizations: Pathologic Processes: Recurrence: Pathological Conditions, Signs and Symptoms: Polymerase Chain Reaction: Reverse Transcriptase Polymerase Chain Reaction: Disease Attributes: Diseases: Health CareCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
