Biomarkers for Adjuvant Endocrine and Chemotherapy in Early-Stage Breast Cancer: ASCO Guideline Update

被引：218

作者：

Andre, Fabrice ^{[1
]}

Ismaila, Nofisat ^{[2
]}

Allison, Kimberly H. ^{[3
]}

Barlow, William E. ^{[4
]}

Collyar, Deborah E. ^{[5
]}

Damodaran, Senthil ^{[6
]}

Henry, N. Lynn ^{[7
]}

Jhaveri, Komal ^{[8
,9
]}

Kalinsky, Kevin ^{[10
]}

Kuderer, Nicole M. ^{[11
]}

Litvak, Anya ^{[12
]}

Mayer, Erica L. ^{[13
]}

Pusztai, Lajos ^{[14
]}

Raab, Rachel ^{[15
]}

Wolff, Antonio C. ^{[16
]}

Stearns, Vered ^{[16
]}

机构：

[1] Inst Gustave Roussy, Paris, France

[2] Amer Soc Clin Oncol, 2318 Mill Rd,Suite 800, Alexandria, VA 22314 USA

[3] Stanford Univ, Med Ctr, Stanford, CA 94305 USA

[4] Canc Res & Biostat, Seattle, WA USA

[5] Patient Advocates Res PAIR, Danville, CA USA

[6] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA

[7] Univ Michigan, Rogel Canc Ctr, Ann Arbor, MI 48109 USA

[8] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[9] Weill Cornell Med Coll, New York, NY USA

[10] Emory Univ, Winship Canc Inst, Atlanta, GA 30322 USA

[11] Adv Canc Res Grp, Kirkland, WA USA

[12] St Barnabas Hosp, Canc Ctr, Livingston, NJ USA

[13] Dana Farber Canc Inst, Boston, MA 02115 USA

[14] Yale Canc Ctr, New Haven, CT USA

[15] Messino Canc Ctr, Asheville, NC USA

[16] Johns Hopkins Univ, Baltimore, MD USA

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2022年 / 40卷 / 16期

关键词：

TUMOR-INFILTRATING LYMPHOCYTES; 21-GENE RECURRENCE SCORE; CLINICAL ONCOLOGY; AMERICAN SOCIETY; PROGNOSTIC VALUE; ESTROGEN-RECEPTOR; SYSTEMIC THERAPY; NEOADJUVANT CHEMOTHERAPY; TREATMENT DECISIONS; DISTANT RECURRENCE;

D O I：

10.1200/JCO.22.00069

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSE To update recommendations on appropriate use of breast cancer biomarker assay results to guide adjuvant endocrine and chemotherapy decisions in early-stage breast cancer. METHODS An updated literature search identified randomized clinical trials and prospective-retrospective studies published from January 2016 to October 2021. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert Panel members used informal consensus to develop evidence-based recommendations. RESULTS The search identified 24 studies informing the evidence base. RECOMMENDATIONS Clinicians may use Oncotype DX, MammaPrint, Breast Cancer Index (BCI), and EndoPredict to guide adjuvant endocrine and chemotherapy in patients who are postmenopausal or age > 50 years with early-stage estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative (ER+ and HER2-) breast cancer that is node-negative or with 1-3 positive nodes. Prosigna and BCI may be used in postmenopausal patients with node-negative ER+ and HER2- breast cancer. In premenopausal patients, clinicians may use Oncotype in patients with node-negative ER+ and HER2- breast cancer. Current data suggest that premenopausal patients with 1-3 positive nodes benefit from chemotherapy regardless of genomic assay result. There are no data on use of genomic tests to guide adjuvant chemotherapy in patients with >= 4 positive nodes. Ki67 combined with other parameters or immunohistochemistry 4 score may be used in postmenopausal patients without access to genomic tests to guide adjuvant therapy decisions. BCI may be offered to patients with 0-3 positive nodes who received 5 years of endocrine therapy without evidence of recurrence to guide decisions about extended endocrine therapy. None of the assays are recommended for treatment guidance in individuals with HER2-positive or triple-negative breast cancer. Treatment decisions should also consider disease stage, comorbidities, and patient preferences.

引用

页码：1816 / +

页数：30

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