GENOMIC TESTS FOR BREAST CANCER: FACT, MYTH, AND EVERYTHING IN BETWEEN
|
|
- Winifred Conley
- 5 years ago
- Views:
Transcription
1 GENOMIC TESTS FOR BREAST CANCER: FACT, MYTH, AND EVERYTHING IN BETWEEN Adam Brufsky, MD, PhD Professor of Medicine Associate Chief, Hematology-Oncology Associate Director, Clinical Investigation University of Pittsburgh Cancer Institute University of Pittsburgh
2 DISCLOSURES Consulting fees from Agendia Genomic Health Biotheranostics Nanostring Technologies
3 Why are we here? Oncologists have a lot of powerful tools Many of them are very toxic Some of them are of great benefit Toxicity and benefit often do not correlate We try to understand natural history of cancer We try to understand benefit of intervention Goal: Do what is right for the patient
4 Clinical Prognosticators-Adjuvant! online
5 Clinical Predictors: PREDICT-PLUS PREDICT Plus: development and validation of a prognostic model for early breast cancer that includes HER2. Wishart GC, et al. Br. J. Cancer 2012;107(5):800-7.
6 Tumor Grade Rakha et al. Breast Cancer Res 2010, 12: 207.
7 Reproducibility of tumor histological grade Kappa: for inter-observer variability Despite the objective improvements that have been made to breast cancer grading methods, any assessment of morphological characteristics inevitably retains a subjective element and is heavily dependent on the pre-analytical parameters. Rakha et al. Breast Cancer Res 2010, 12: 207.
8 How Good are Clinical Predictors They are not useless However, there is some subjectivity in certain important measurements, such as grade What else can be done to reduce subjectivity?
9 Oncotype DX (RT-PCR Technology) 16 Cancer and 5 Reference Genes PROLIFERATION Ki-67 STK15 Survivin Cyclin B1 MYBL2 INVASION Stromolysin 3 Cathepsin L2 HER2 GRB7 HER2 CD68 ESTROGEN ER PR Bcl2 SCUBE2 GSTM1 BAG1 REFERENCE Beta-actin GAPDH GUS RPLPO TFRC RS Weighting: x HER2 Group x ER Group x Proliferation Group x Invasion Group x CD x GSTM x BAG1 Category RS (0 100) Low risk RS < 18 Intermediate risk RS 18 and < 31 High risk RS 31
10 Recurrence Score and Distant Recurrence-Free Survival Rate of Distant Recurrence at 10 years Low RS < 18 Rec. Rate = 6.8% C.I. = 4.0% - 9.6% Intermediate RS Rec. Rate = 14.3% C.I. = 8.3% % High RS 31 Rec. Rate = 30.5% C.I. = 23.6% % Recurrence Rate 95% C.I Recurrence Score Paik.S. et al. N Engl J Med 2004;351:
11 High RS Result Correlates with Greater Benefit from Chemotherapy (NSABP B-20) Proportion without distant recurrence All patients RS < 18 RS RS 31 Tamoxifen + chemotherapy Tamoxifen Tamoxifen + chemotherapy Tamoxifen Tamoxifen + chemotherapy Tamoxifen Tamoxifen + chemotherapy Tamoxifen N Events P = 0.02 P = 0.61 P = 0.39 P < PATIENTS WITH HIGH RS 28% absolute benefit from tamoxifen + chemotherapy 4.4% absolute benefit from tamoxifen + chemotherapy Years RS, Recurrence Score result Paik S, et al. J Clin Oncol. 2006;24:
12 SWOG 8814: Breast Cancer-Specific Survival of Node-Positive Patients by Treatment and RS Group BREAST CANCER-SPECIFIC SURVIVAL BY TREATMENT RS < 18 RS RS Stratified log-rank P = 0.56 at 10 years CAF T (n = 91, 10 events) Tamoxifen (n = 55, 4 events) Years since registration 10-yr BCSS T: 92% vs CAF T: 87% No benefit to CAF over time for low Recurrence Score Stratified log-rank P = 0.89 at 10 years CAF T (n = 46, 10 events) Tamoxifen (n = 57, 11 events) Years since registration 10-yr BCSS T: 70% vs CAF T: 81% Interaction P = Stratified log-rank P = at 10 years CAF T (n = 47, 18 events) Tamoxifen (n = 71, 20 events) Years since registration 10-yr BCSS T: 54% vs CAF T: 73% Strong benefit to CAF over time for high Recurrence Score RS, Recurrence Score result 12 Albain KS, et al. Lancet Oncol. 2010;11(1):55-65.
13 The 21 gene assay: Savior, or a Devil in the Details? Data is very compelling risk of recurrence, for both N(-) and post-meno N(+) Most important data for the practicing oncologist is in chemotherapy benefit prediction the data is also compelling, but low N N = 164 in B20 N(-) high RS group tam +/- chemo N = 118 in E8814 N(+) high RS group tam+/- chemo What exactly is the RS measuring?
14 Are we simply measuring mrna of genes that we can easily detect by good IHC? 16 Cancer and 5 Reference Genes PROLIFERATION Ki-67 STK15 Survivin Cyclin B1 MYBL2 INVASION Stromolysin 3 Cathepsin L2 HER2 GRB7 HER2 CD68 ESTROGEN ER PR Bcl2 SCUBE2 GSTM1 BAG1 REFERENCE Beta-actin GAPDH GUS RPLPO TFRC RS Weighting: x HER2 Group x ER Group x Proliferation Group x Invasion Group x CD x GSTM x BAG1 Category RS (0 100) Low risk RS < 18 Intermediate risk RS 18 and < 31 High risk RS 31 If you are really, really good at IHC in breast cancer, can you replicate the RS info?
15 The Magee Equations Examined a test set of 817 ER (+), N (-) cases from MWH from with RS results Derived three regression equations based on ER, PR, Her2, Ki67 scores as well as clinical variables on these cases Blinded test on another set of 255 ER (+), N(-) cases from MWH with known RS results Klein et al Modern Pathol (2013) 1-7.
16 The Magee Equations Klein et al Modern Pathol (2013) 1-7.
17 The Magee Equations R=0.61 Klein et al Modern Pathol (2013) 1-7.
18 Using the Biology of Tumor Pathways: Mammaprint and PAM50
19 MammaPrint: A 70 Gene Breast Cancer Prognosis Profile 70 significant prognosis genes Tumor samples van t Veer et al., Nature 415, p , 2002
20 MammaPrint interrogates multiple genomic pathways (no ER/PR/Her2 mrna) IGFBP5, TGFB3, FGF18, ESM1, RARRES3, PITRM1, EXT1, EXTL3, SCUBE2, EBF4,CDC42BPA, CDCA7, CDCA7L, GMPS, MELK, RFC4, WISP1, HRASLS, BBC3, DTL, FBXO31, EGLN1, GNAZ, MTDH, FLT1, ECT2, DIAPH3, NUSAP1, AKAP2, NDC80, PRC1, ORC6L, CENPA, DCK, CCNE2, MCM6, QSOX2, STK32B COL4A2, FLT1, FGF18, MMP9 3. FLT1, TGFB3, IGFBP5, FGF18, RARRES3, CDCA7L, WISP1, DIAPH3, AKAP2, CDC42BPA, PALM2, DCLK2, NMU, NMUR1, NMUR2 4. COL4A2, FLT1, MMP9, TGFB3, MTDH, DIAPH3, PALM2, DCLK2, NMU, NMUR1, NMUR2 5. COL4A2, FLT1, MMP9, TGFB3,, DIAPH3, PALM2, DCLK2, NMU, NMUR1, NMUR COL4A2, FLT1, MMP9, TGFB3, MTDH, DIAPH3, PALM2, DCLK2, NMU, NMUR1, NMUR2 IGFBP5, TGFB3, FGF18, ESM1, RARRES3, PITRM1, EXT1, EXTL3, SCUBE2, EBF4,CDC42BPA, CDCA7, CDCA7L, GMPS, MELK, RFC4, WISP1, HRASLS, BBC3, DTL, FBXO31, EGLN1, GNAZ, MTDH, FLT1, ECT2, DIAPH3, NUSAP1, AKAP2, NDC80, PRC1, ORC6L, CENPA, DCK, CCNE2, MCM6, QSOX2, STK32B MMP9, COL4A2 COL4A2, FLT1, MMP9, TGFB3, MTDH, DIAPH3, PALM2, DCLK2, NMU, NMUR1, NMUR2
21 Chemotherapy benefit in MammaPrint LOW RISK patients (n=252) DDFS: MammaPrint LOW RISK (n=252) BCSS: MammaPrint LOW RISK (n=252) Percent survival ET (n=174, 69%) ET+CT (n=78, 31%) HR 0.26 ( ) p= % 93% Percent survival ET (n=174, 69%) ET+CT (n=78, 31%) HR 0.58 ( ) p= % 97% Time in years Time in years Knauer et al., Breast Cancer Res Treat, 2010 Feb
22 Percent survival Chemotherapy benefit in MammaPrint HIGH RISK patients (n=289) DDFS: MammaPrint HIGH RISK (n=289) ET (n=141, 49%) ET+CT (n=148, 51%) HR 0.35 ( ) p< Time in years 88% 76% Percent survival BCSS: MammaPrint HIGH RISK (n=289) ET (n=141, 49%) ET+CT (n=148, 51%) HR 0.21 ( ) p< Time in years 94% 81% 12% absolute benefit 50% relative benefit 13% absolute benefit 68% relative benefit Knauer et al., Breast Cancer Res Treat, 2010 Feb
23 MammaPrint in LN+ patients S. Mook et al. (2009) Breast Cancer Res Treat.
24 What are Intrinsic Molecular Subtypes? Molecular subtypes show which pathway drives cancer growth. Luminal is driven by the estrogen pathway ERBB2 is driven by the HER2 pathway Basal is driven by neither one of them
25 ERBB2 amplicon cluster Novel unknown cluster Basal epithelial cluster Normal breast like cluster Luminal epithelial gene cluster Sorlie T et al. PNAS. 2001;
26 80-gene BluePrint Profile Breast Cancer Analysis of Entire Human Genome ~25,000 Genes Basal, Luminal, and HER2-type BluePrint Basal-Type Luminal-Type classification HER2-Type Prognostic & Predictive Breast Cancer Genes Identified
27 IHC and Intrinsic Subtype Not Always Correlated (Gluck et al, Int J Ca, 2013)
28 22% of HER2+ patients is MammaPrint Low Risk HER2 gene is not part of the 70 genes Distant disease free survival without any adjuvant thereapy Knauer et al. Br J Cancer, 2010
29 Intrinsic Subtype Clinical Assay Development Took the initial instrinsic classifer of 496 genes Developed a final classifier consisting of 50 genes and 5 centroids (provided at The CV classification accuracy of the 50 genes versus the 496 genes was 93%. The assay is called the PAM50 Parker et al., JCO, February 9, 2009
30 PAM50 by NanoString ncounter Extract RNA from FFPE tumor sample Run RNA & PAM50 CodeSet on ncounter Analysis System Capture patient expression profile Determine Intrinsic Subtype through Pearson s Correlation to Centroids Patient expression profile LumA PAM50 centroids Calculate Risk of Recurrence (ROR) Score ROR =ar LumA + br LumB + cr Her2e + dr Basal + ep+ Pearson s correlation to centroids* Proliferation score (19 genes) ft Tumor size
31 TransATAC: Study Design ATAC Study Postmenopausal women with invasive BC TAM alone (n = 3,116) TAM + Arimidex (n = 3,125) Arimidex alone (n = 3,125) TransATAC Study (N = 1,017) Samples from AstraZeneca -sponsored ATAC study of anastrozole (aromatase inhibitor) gene test study: RS valid in patients treated with aromatase inhibitors 2011 PAM50 study: Tested excess RNA from 2008 study with PAM50 Dowsett M, et al. J Clin Oncol. 2013;31(22):
32 TransATAC: ROR Score Discriminates Recurrence Risk Within Nodal Subgroups Percent Without Distant Recurrence Node-Negative Patients Low (n=431) Medium (n=180) High (n=128) Follow-up Time, years Percent Without Distant Recurrence Node-Positive Patients (1-3 nodes) Low (n=6) Medium (n=74) High (n=134) Follow-up Time, years Risk Group N (%) Events a % Without Recurrence at 10 years Low 431 (58) 17 96% (94%-98%) Intermediate 180 (24) 22 86% (81%-92%) High 128 (17) 38 67% (59%-76%) a Number of events through 10 years. 1. Dowsett, M. et al. J Clin Oncol. 2013;31(22): Risk Group N (%) Events a % Without Recurrence at 10 years Low 6 (3) 0 100% (N/A) Intermediate 74 (35) 11 84% (76%-93%) High 134 (63) 38 68% (59%-77%) a Number of events through 10 years. 32
33 Prosigna (PAM50) Gene Signature Assay Risk Groups Better Characterize Late Recurrence Prosigna provides greater insight into probability of breast cancer recurrence between Year 5 and 10 after diagnosis Beyond 5 years, the ROR score discriminates the risk of distant recurrence much better than RS Percent without Distant Recurrence, % Low ROR score High ROR score Low RS score High RS score RS=Recurrence score Follow-up Time, years Sestak I, et al. J Natl Cancer Inst. 2013;105(19):
34 ABCSG-8: Study Background and Patients Included in PAM50 Analysis Primary Surgery 3,714 eligible for ABCSG-8 Randomization 1,671 re-consented or deceased Tamoxifen 20 mg 2 years Tamoxifen 20 mg 3 years Tamoxifen 20 mg 2 years Anastrozole 1 mg 3 years 1,620 FFPE blocks collected 25 insufficient tumor tissue in specimen 73 insufficient RNA isolated 44 failed QC specs for device 1,478 evaluable tissue specimens Gnant M, et al. Ann Oncol. 2014;25(2):
35 ABCSG8 Study: Prosigna Identified Low-Risk Patients Node negative Patients Node positive Patients (1-3 nodes) Risk Group N (%) Events % without recurrence at 10 yr Low 487 (47%) 15 97% [94%-98%] Intermediate 335 (32%) 28 90% [86%-93%] High 225 (21%) 32 84% [78%-89%] Total 1,047 Risk Group N (%) Events % without recurrence at 10 yr Low 158 (41%) 7 94% [88%-97%] High 224 (59%) 46 76% [69%-81%] Total 382 Gnant M, et al. Ann Oncol. 2014;25(2):
36 ABCSG8: 15-year risk of distance recurrence Risk group Number of patients (%) Number of Events through 10-years Low 502 (34%) 15 Estimated % Without Recurrence at 10 years [95% CI] 15 years [95% CI] 96.7% [94.6%-98.0%] 95.6% [92.7%-97.3%] Intermediate 478 (32%) 35 High 498 (34%) % [88.1%-93.8%] 79.9% [75.7%-83.4%] 87.3% [82.3%-90.9%] 72.1% [65.2%-77.8%] Total 1,478 (100%) % [87.7%-91.1%] 84.9% [81.9%-87.5%] 36 Gnant M et al. Ann Oncol. 2014;25(2): Gnant M et al. Ann Oncol 2013 May 1, 2013;24(suppl 3):iii29.
37 Danish Breast Cancer Group (DBCG) study of endocrine therapy DBCG is the national cooperative group in Denmark Sets treatment guidelines for all patients in Denmark strictly followed Collects outcome data for all patients in Denmark into a single centralized, registration-quality database Facilitates collection of tumor blocks From all high risk HR+, post-menopausal patients received 5 years of endocrine therapy alone Node-positive or Node-negative with T>2cm, or Grade II/III First genomic study of a comprehensive national cohort of breast cancer patients 2971 patients eligible in the database in this period 2749 blocks collected (92%) Node positive : N = 1480 Late recurrence analysis: N = 2722 Analyzed ROR and subtype ability to predict 10 year recurrence, late recurrence, and recurrence for 1, 2, 3+ nodes (risk cutpoints depending on #nodes)
38 DBCG 10 year Distant Recurrence Analysis* Cumulative Incidence by Risk Group Cumulative Incidence by Subtype All Patients * P values Nodal Status Risk Category 10-Year DR [95% CI] Any Diff. Diff. from Int Intermediate 9.6 [ ] < High 20.8 [ ] < Low 4.3 [ ] High 18.5 [ ] < Node- Intermediate 7.3 [ ] < Negative Low 4.9 [ ] Node- High 21.9 [ ] Positive (1-3 < NA nodes) ** Low 4.8 [ ] Intrinsic Subtype Node Negative N [%] Node-Positive (1-3 Nodes) Prob of 10-yr DR [95% CI] Node-Negative Node-Positive (1-3 Nodes) Luminal A 632 [50.3%] 883 [60.2%] 6.3% [ ] 8.7% [ ] Luminal B 502 [40.0%] 475 [32.4%] 14.1% [ ] 22.2 [ ] Luminal A/B P-value - - < < Laenkholm et al, ASCO poster 2015
39 DBCG Late Distant Recurrence Cumulative Incidence by Risk Group Cumulative Incidence by Subtype Patient Risk Prob of late DR P values N (%) Group [95%CI] Any Diff. Diff. from Int. High 870 (40%) 10.2% [ ] Intermediate 650 (30%) 6.1% [ ] < Low 644 (30%) 2.4% [ ] Subtype N (%) Prob of late DR [95%CI] Any Diff. Diff. from LumA Luminal A 1281 (59%) 4.5% [ ] - Luminal B 733 (34%) 10.3% [ ] < Her2-Enriched 132 (6%) 8.8% [ ] Basal-Like 18 (1%) Laenkholm et al. Poster ASCO 2015
40 DBCG Comprehensive Cohort Study: Analysis of Node Positive Patients Cumulative Incidence for 1 Positive Node Cumulative Incidence for 2 Positive Nodes Characteristic Number of Positive Nodes Age N (% of 1+node) N (% of 2+node) N (% of 3+node) (39%) 172 (40%) 93 (40%) (41%) 166 (39%) 95 (41%) (20%) 88 (21%) 43 (19%) Tumor Size (10%) 32 (8%) 11 (5%) (51%) 185 (43%) 94 (41%) (26%) 136 (32%) 76 (33%) > (13%) 73 (17%) 50 (22%) Histological Subtype Ductal 663 (82%) 352 (83%) 191 (83%) Lobular 114 (14%) 62 (15%) 34 (15%) Other 32 (4%) 12 (3%) 6 (3%) Histological Grade (34%) 129 (30%) 77 (33%) (45%) 198 (46%) 101 (44%) Nodal Status Risk Category N 10-Year DR [95% CI] All Patients (1-3 Positive Nodes) 1-Positive Node 2-Positive Nodes 3-Positive Nodes High % [ ] P values Any Diff. Diff. from Int < Intermediate % [ ] < Low % [ ] High % [ ] Int % [ ] < Low % [ ] High % [ ] Int % [ ] Low % [ ] High % [ ] Int 26 0% [NA] Low N/A (11%) 52 (12%) 28 (12%) Source: Ejlertsen et. al., ASCO 2015, Poster #513 Not done 86 (11%) 47 (11%) 25 (11%) 21
41 The Future
42 Prospective Validation of Oncotype DX: The TAILORX Trial 11,248 ER+/LN- patients Low RS: Hormonal Therapy High RS: Chemo + Hormonal Therapy Hormonal Therapy Chemo + Hormonal Dowsett, M. & Dunbier, A. Clin Cancer Res, 2008.
43 Kaplan Meier Estimates in the Analyses of Invasive Disease free Survival, Freedom from Recurrence of Breast Cancer at a Distant Site, Freedom from Recurrence at Any Site, and Overall Survival. Sparano JA et al. N Engl J Med 2015;373:
44 Prospective Validation of Oncotype DX for N(+): RxPonder (S1007)
45
46 Piccart, AACR, 2016
47 Piccart, AACR, 2016
48 Piccart, AACR, 2016
49 Piccart, AACR, 2016
50 Piccart, AACR, 2016
51 Piccart, AACR, 2016
52 Piccart, AACR, 2016
53 Piccart, AACR 2016
54 Piccart, AACR, 2016
55 Piccart, AACR, 2016
56 Piccart, AACR, 2016
57 Piccart, AACR, 2016
58 Implications for Clinical Practice MINDACT is clearly practice changing Genomic high/clinical high has 91% DMFS with modern screening and chemotherapy Genomic low/clinical high has 5 years DMFS of 95% when treated with ET alone Includes 1-3 positive node Includes ER positive, Her2 positive (node neg?) Chemo saved in 48% of clinical high risk patients
59 Comparison of Gene Sets Only 34 of these genes are known to be involved in a specific pathway* *According to
60 NCCN Guidelines Update
61 What Do We Do Now? We should attempt some sort of prescreen (clinicalpathologic variables, Adjuvant! Online, NHS Predict, Magee Equations) prior to ordering multiparametric genomic test If insurers allow ONE test ER (+) LN(-) Mammaprint, Pam 50 or ODx if Magee Equation Int/High Mammaprint in Her2 (+), T1, ER pos ER (+), LN (+): Mammaprint, PAM50, or ODx in postmeno LN (+) Mammaprint in premeno LN (+)
The Changing Landscape of Breast Cancer Management and Treatment
The Changing Landscape of Breast Cancer Management and Treatment Nathalie Johnson, MD, FACS Medical Director of the Legacy Cancer Institute and Breast Health Centers Objectives Review current screening
More informationAssessment of Risk Recurrence: Adjuvant Online, OncotypeDx & Mammaprint
Assessment of Risk Recurrence: Adjuvant Online, OncotypeDx & Mammaprint William J. Gradishar, MD Professor of Medicine Robert H. Lurie Comprehensive Cancer Center of Northwestern University Classical
More information8/8/2011. PONDERing the Need to TAILOR Adjuvant Chemotherapy in ER+ Node Positive Breast Cancer. Overview
Overview PONDERing the Need to TAILOR Adjuvant in ER+ Node Positive Breast Cancer Jennifer K. Litton, M.D. Assistant Professor The University of Texas M. D. Anderson Cancer Center Using multigene assay
More informationRole of Genomic Profiling in (Minimally) Node Positive Breast Cancer
Role of Genomic Profiling in (Minimally) Node Positive Breast Cancer Kathy S. Albain, MD, FACP Professor of Medicine Dean s Scholar Loyola University Chicago Stritch School of Medicine Cardinal Bernardin
More informationShe counts on your breast cancer expertise at the most vulnerable time of her life.
HOME She counts on your breast cancer expertise at the most vulnerable time of her life. Empowering the right treatment choice for better patient outcomes. The comprehensive genomic assay experts trust.
More informationThe Oncotype DX Assay in the Contemporary Management of Invasive Early-stage Breast Cancer
The Oncotype DX Assay in the Contemporary Management of Invasive Early-stage Breast Cancer Cancer The Biology Century Understanding and treating the underlying tumor biology Cancer genetic studies demonstrate
More informationOVERVIEW OF GENE EXPRESSION-BASED TESTS IN EARLY BREAST CANCER
OVERVIEW OF GENE EXPRESSION-BASED TESTS IN EARLY BREAST CANCER Aleix Prat, MD PhD Medical Oncology Department Hospital Clínic of Barcelona University of Barcelona esmo.org Disclosures Advisory role for
More informationIs Gene Expression Profiling the Best Method for Selecting Systemic Therapy in EBC? Norman Wolmark Miami March 8, 2013
Is Gene Expression Profiling the Best Method for Selecting Systemic Therapy in EBC? Norman Wolmark Miami March 8, 2013 Changing Phases claudin low Lum A Lum B Basal Her2 NIH Consensus Development Panel,
More informationThe Oncotype DX Assay A Genomic Approach to Breast Cancer
The Oncotype DX Assay A Genomic Approach to Breast Cancer Pathology: 20 th and 21 st Century Size Age Phenotype Nodal status Protein/Gene Genomic Profiling Prognostic & Predictive Markers Used in Breast
More informationGenomic Profiling of Tumors and Loco-Regional Recurrence
1 Genomic Profiling of Tumors and Loco-Regional Recurrence Terry Mamounas, M.D., M.P.H., F.A.C.S. Medical Director, Comprehensive Breast Program UF Health Cancer Center at Orlando Health Professor of Surgery,
More informationComparison of prognostic signatures for ER positive breast cancer in TransATAC:
Comparison of prognostic signatures for ER positive breast cancer in TransATAC: EndoPredict, a high performance test in node negative and node positive disease Ivana Sestak, PhD Centre for Cancer Prevention
More information30 years of progress in cancer research
Breast Cancer Molecular Knowledge Integrated in Clinical Practice Personalized Medicine Laura J. Esserman UCSF Comprehensive Cancer Center Retreat Breast Cancer Management Advances 80-90s 1) Screening
More informationOncotype DX testing in node-positive disease
Should gene array assays be routinely used in node positive disease? Yes Christy A. Russell, MD University of Southern California Oncotype DX testing in node-positive disease 1 Validity of the Oncotype
More informationRationale For & Design of TAILORx. Joseph A. Sparano, MD Albert Einstein College of Medicine Montefiore-Einstein Cancer Center Bronx, New York
Rationale For & Design of TAILORx Joseph A. Sparano, MD Albert Einstein College of Medicine Montefiore-Einstein Cancer Center Bronx, New York Declining Breast Cancer Mortality & Event Rates in Adjuvant
More informationThe Current Status and the Future Prospects of Multigene testing in Europe
The Current Status and the Future Prospects of Multigene testing in Europe Emiel J. Rutgers The Netherlands Cancer Institute Antoni Van Leeuwenhoek Hospital Amsterdam St. Gallen Recommendations 2009 =
More informationMorphological and Molecular Typing of breast Cancer
Morphological and Molecular Typing of breast Cancer Ian Ellis Molecular Medical Sciences, University of Nottingham Department of Histopathology, Nottingham University Hospitals NHS Trust Histological
More informationMultigene Testing in NCCN Breast Cancer Treatment Guidelines, v1.2011
Multigene Testing in NCCN Breast Cancer Treatment Guidelines, v1.2011 Robert W. Carlson, M.D. Professor of Medicine Stanford University Chair, NCCN Breast Cancer Treatment Guidelines Panel Selection of
More informationAdjuvant endocrine therapy (essentials in ER positive early breast cancer)
Adjuvant endocrine therapy (essentials in ER positive early breast cancer) Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Experimental Therapeutics Outline Picking optimal adjuvant endocrine
More informationProsigna BREAST CANCER PROGNOSTIC GENE SIGNATURE ASSAY
Prosigna BREAST CANCER PROGNOSTIC GENE SIGNATURE ASSAY Methodology The test is based on the reported 50-gene classifier algorithm originally named PAM50 and is performed on the ncounter Dx Analysis System
More informationProsigna BREAST CANCER PROGNOSTIC GENE SIGNATURE ASSAY
Prosigna BREAST CANCER PROGNOSTIC GENE SIGNATURE ASSAY GENE EXPRESSION PROFILING WITH PROSIGNA What is Prosigna? Prosigna Breast Cancer Prognostic Gene Signature Assay is an FDA-approved assay which provides
More informationGene Signatures in Breast Cancer: Moving Beyond ER, PR, and HER2? Lisa A. Carey, M.D. University of North Carolina USA
Gene Signatures in Breast Cancer: Moving Beyond ER, PR, and HER2? Lisa A. Carey, M.D. University of North Carolina USA When Are Biomarkers Ready To Use? Same Rules for Gene Expression Panels Key elements
More informationProfili Genici e Personalizzazione del trattamento adiuvante nel carcinoma mammario G. RICCIARDI
Profili Genici e Personalizzazione del trattamento adiuvante nel carcinoma mammario G. RICCIARDI UOC Oncologia Medica, A.O. Papardo, Messina Dir. Prof. V. Adamo BREAST CANCER Brain Adjuvant Medical Therapies
More informationBreast cancer classification: beyond the intrinsic molecular subtypes
Breast cancer classification: beyond the intrinsic molecular subtypes Britta Weigelt, PhD Signal Transduction Laboratory CRUK London Research Institute Summary Breast cancer heterogeneity Molecular classification
More informationGenomic platforms in breast cancer
Genomic platforms in breast cancer Prof. Miguel Martín Instituto de Investigación Sanitaria Hospital Gregorio Marañón Universidad Complutense Madrid mmartin@geicam.org Disclosure Dr. Martin has received
More informationSeigo Nakamura,M.D.,Ph.D.
Seigo Nakamura,M.D.,Ph.D. Professor of Surgery Director of Breast Center Showa University Hospital Chairman of the board of directors Japan Breast Cancer Society Inhibition of Estrogen-Dependent Growth
More informationMolecular Characterization of Breast Cancer: The Clinical Significance
Molecular Characterization of : The Clinical Significance Shahla Masood, M.D. Professor and Chair Department of Pathology and Laboratory Medicine University of Florida College of Medicine-Jacksonville
More informationHigh False-Negative Rate of HER2 Quantitative Reverse Transcription Polymerase Chain Reaction of the Oncotype DX
High False-Negative Rate of HER2 Quantitative Reverse Transcription Polymerase Chain Reaction of the Oncotype DX Test: An Independent Quality Assurance Study DAVID J DABBS, MD Professor and Chief of Pathology
More informationGenomic Profiling in Early Stage Breast Cancer. James V. Pellicane, MD, FACS Director of Breast Oncology Bon Secours Cancer Institute Richmond, VA
Genomic Profiling in Early Stage Breast Cancer James V. Pellicane, MD, FACS Director of Breast Oncology Bon Secours Cancer Institute Richmond, VA 1 Disclosures Speakers Bureau Agendia Focal Therapeutics
More informationA new way of looking at breast cancer tumour biology
A new way of looking at breast cancer tumour biology Contents Intrinsic subtypes of breast cancer 3 Gene expression assays 3 Basis of the Prosigna test 4 Information provided by Prosigna 5 The accuracy
More informationBiologic Subtypes and Prognos5c Factors. Claudine Isaacs, MD Georgetown University
Biologic Subtypes and Prognos5c Factors Claudine Isaacs, MD Georgetown University Prognos5c Factor Defini5on Predicts outcome in absence of systemic therapy Thus tell us when (not how) to treat a pa5ent
More informationProfili di espressione genica
Profili di espressione genica Giampaolo Bianchini MD Ospedale San Raffaele, Milan - Italy Gene expression profiles Transcriptomics Gene DNA mrna mirnas Protein metilation Metabolite Genomics Transcriptomics
More informationHarmesh Naik, MD. Hope Cancer Clinic
Harmesh Naik, MD. Hope Cancer Clinic A brief review of adjuvant therapy of breast cancer Summarize selected new developments in adjuvant therapy of breast cancer Discussion is limited to early stage breast
More informationOncotype DX reveals the underlying biology that changes treatment decisions 37% of the time
Oncotype DX reveals the underlying biology that changes treatment decisions 37% of the time Even when treatment decisions based on traditional measures seem conclusive, Oncotype DX can lead to a different
More informationTAILORx: Established and Potential Implications for Clinical Practice
TAILORx: Established and Potential Implications for Clinical Practice Joseph A. Sparano, MD Study Chair, TAILORx Vice-Chair, ECOG-ACRIN Cancer Research Group Hello Healthcare Summit Berlin, Germany March
More informationHormone therapyduration: Can weselectthosepatientswho benefitfromtreatmentextension?
Hormone therapyduration: Can weselectthosepatientswho benefitfromtreatmentextension? Ivana Sestak, PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University London
More informationMaking Understanding Molecular Profiles Less Painful. Presenter Disclosure Information
Welcome to Master Class for Oncologists Miami, FL December 18, 2009 Session 1: 1:00 PM - 1:45 PM Towards Personalized Medicine in Breast Cancer: Understanding Molecular Subtypes and the Role of Diagnostics
More informationThe Latest Research: Hormonal Therapies
The Latest Research: Hormonal Therapies Sameer Gupta, M.D., M.P.H 9/29/2018 Attending Physician, Hematology/Oncology Bryn Mawr Hospital Clinical Assistant Professor, Jefferson Medical College Disclosures
More informationExtended Hormonal Therapy
Extended Hormonal Therapy Dr. Caroline Lohrisch, Medical Oncologist, BC Cancer Agency Vancouver Centre November 1, 2014 www.fpon.ca Optimal Endocrine Therapy for Women with Hormone Receptor Positive Early
More informationIII Congreso Internacional de Oncologia del Interior XII Jornadas de Oncologia del Interior Cordoba Argentina. Farmacogenomica y Cancer de Mama
III Congreso Internacional de Oncologia del Interior XII Jornadas de Oncologia del Interior Cordoba Argentina Farmacogenomica y Cancer de Mama Vicente Valero, M.D., F.A.C.P. Professor of Medicine Deputy
More informationRelevancia práctica de la clasificación de subtipos intrínsecos en cáncer de mama Miguel Martín Instituto de Investigación Sanitaria Gregorio Marañón
Relevancia práctica de la clasificación de subtipos intrínsecos en cáncer de mama Miguel Martín Instituto de Investigación Sanitaria Gregorio Marañón Universidad Complutense Madrid The new technologies
More informationBreast cancer: Molecular STAGING classification and testing. Korourian A : AP,CP ; MD,PHD(Molecular medicine)
Breast cancer: Molecular STAGING classification and testing Korourian A : AP,CP ; MD,PHD(Molecular medicine) Breast Cancer Theory: Halsted Operative breast cancer is a local-regional disease The positive
More informationContemporary Classification of Breast Cancer
Contemporary Classification of Breast Cancer Laura C. Collins, M.D. Vice Chair of Anatomic Pathology Professor of Pathology Beth Israel Deaconess Medical Center and Harvard Medical School Boston, MA Outline
More informationSession thématisée Les Innovations diagnostiques en cancérologie
10 èmes Journées Scientifiques du Cancéropôle Nord-Ouest 10-12 mai 2017, Deauville Session thématisée Les Innovations diagnostiques en cancérologie Les signatures multigéniques pronostiques dans le cancer
More informationClinical utility of multigene profiling assays in early-stage breast cancer
PRACTICE GUIDELINE CLINICAL UTILITY OF MULTIGENE PROFILING ASSAYS, Chang et al. Clinical utility of multigene profiling assays in early-stage breast cancer M.C. Chang md phd,* L.H. Souter phd, S. Kamel-Reid
More information1 INTRODUCTION REVIEW ARTICLE
Received: 12 December 2016 Revised: 15 December 2016 Accepted: 15 December 2016 DOI 10.1002/jso.24561 REVIEW ARTICLE Selecting postoperative adjuvant systemic therapy for early stage breast cancer: A critical
More informationTHE 21-GENE RECURRENCE SCORE: BEATSON WEST OF SCOTLAND CANCER CENTRE EXPERIENCE. Dr Husam Marashi 03/02/2017
THE 21-GENE RECURRENCE SCORE: BEATSON WEST OF SCOTLAND CANCER CENTRE EXPERIENCE Dr Husam Marashi 03/02/2017 THE 21-GENE RECURRENCE SCORE: BEATSON WEST OF SCOTLAND CANCER TODAY S TALK: CENTRE EXPERIENCE
More informationBreast Cancer Heterogeneity
Breast Cancer Heterogeneity Session 2: 8:15 AM 9:00 AM Molecular Subsets and Molecular Diagnostics in Breast Cancer ER + subtypes ER-negative subtypes Lisa A. Carey, MD University of North Carolina Lineberger
More informationModern classification of breast cancer-should we stick with morphology or convert to molecular profiles?
Modern classification of breast cancer-should we stick with morphology or convert to molecular profiles? Ian Ellis Professor of Cancer Pathology Molecular Medical Sciences University of Nottingham Dept
More informationEvolving Insights into Adjuvant Chemotherapy. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology
Evolving Insights into Adjuvant Chemotherapy Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology 80 70 60 50 40 30 20 10 0 EBCTCG 2005/6 Overview Control Arms with No Systemic
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Assays of Genetic Expression in Tumor Tissue as a Technique Page 1 of 67 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Assays of Genetic Expression in Tumor Tissue
More informationKathy Albain, MD. Chemotherapy in Luminal Breast Cancer: Who Benefits? Loyola University Chicago Stritch School of Medicine
Chemotherapy in Luminal Breast Cancer: Who Benefits? Kathy Albain, MD Loyola University Chicago Stritch School of Medicine, Director, Breast Clinical Research Program, Cardinal Bernardin Cancer Center,
More informationBradley M Turner MD, MPH, MHA. Assistant Professor University of Rochester Department of Pathology and Laboratory Medicine
Bradley M Turner MD, MPH, MHA Assistant Professor University of Rochester Department of Pathology and Laboratory Medicine My real job!!! I have nothing to disclose although Oncotype Dx year end revenues
More informationBreast Cancer Assays of Genetic Expression in Tumor Tissue
Breast Cancer Assays of Genetic Expression in Tumor Tissue Policy Number: Original Effective Date: MM.12.009 12/01/2008 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 12/16/2016
More informationPostoperative Adjuvant Chemotherapies. Stefan Aebi Luzerner Kantonsspital
Postoperative Adjuvant Chemotherapies Stefan Aebi Luzerner Kantonsspital stefan.aebi@onkologie.ch Does Chemotherapy Work in Older Patients? ER : Chemotherapy vs nil Age
More informationAdjuvant Endocrine Therapy: How Long is Long Enough?
Adjuvant Endocrine Therapy: How Long is Long Enough? Harold J. Burstein, MD, PhD Dana-Farber Cancer Institute Harvard Medical School Boston, Massachusetts hburstein@partners.org I have no conflicts to
More informationBREAST CANCER. Dawn Hershman, MD MS. Medicine and Epidemiology Co-Director, Breast Program HICCC Columbia University Medical Center.
BREAST CANCER Dawn Hershman, MD MS Florence Irving Assistant Professor of Medicine and Epidemiology Co-Director, Breast Program HICCC Columbia University Medical Center Background Breast cancer is the
More informationBreast Cancer Assays of Genetic Expression in Tumor Tissue
Breast Cancer Assays of Genetic Expression in Tumor Tissue Policy Number: Original Effective Date: MM.12.009 12/02/2008 Line(s) of Business: Current Effective Date Section: 05/25/2018 Other Miscellaneous
More informationCase Study Oncotype DX Breast Cancer Assay
Case Study Oncotype DX Breast Cancer Assay Steven Shak, MD Chief Medical Officer, Genomic Health IOM Workshop on the Review of Omics-Based Tests November 16, 2010 Trastuzumab For Herceptest Positive Breast
More informationConsiderations in Adjuvant Chemotherapy. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology
Considerations in Adjuvant Chemotherapy Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology 80 70 60 50 40 30 20 10 0 EBCTCG 2005/6 Overview Control Arms with No Systemic Treatment
More information11th Annual Population Health Colloquium. Stan Skrzypczak, MS, MBA Sr. Director, Marketing Genomic Health, Inc. March 15, 2011
11th Annual Population Health Colloquium Stan Skrzypczak, MS, MBA Sr. Director, Marketing Genomic Health, Inc. March 15, 2011 Agenda Personalized medicine in oncology healthcare Clinical relevance of personalized
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Assays of Genetic Expression in Tumor Tissue as a Technique Page 1 of 55 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Assays of Genetic Expression in Tumor Tissue
More informationThe TAILORx Trial: A review of the data and implications for practice
The TAILORx Trial: A review of the data and implications for practice Angela DeMichele, MD, MSCE Jill & Alan Miller Endowed Chair in Breast Cancer Excellence Professor of Medicine and Epidemiology University
More informationMedical Policy. Description. Related Policies. Policy. Effective Date January 1, 2015 Original Policy Date December 1, 2005
2.04.36 Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer Section 2.0 Medicine Subsection 2.04 Pathology/Laboratory Effective Date January
More informationMP Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients With Breast Cancer. Related Policies None
Medical Policy Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients With Breast BCBSA Ref. Policy: 2.04.36 Last Review: 11/15/2018 Effective Date: 02/15/2019 Section:
More informationRNA preparation from extracted paraffin cores:
Supplementary methods, Nielsen et al., A comparison of PAM50 intrinsic subtyping with immunohistochemistry and clinical prognostic factors in tamoxifen-treated estrogen receptor positive breast cancer.
More informationReliable Evaluation of Prognostic & Predictive Genomic Tests
Reliable Evaluation of Prognostic & Predictive Genomic Tests Richard Simon, D.Sc. Chief, Biometric Research Branch National Cancer Institute http://brb.nci.nih.gov Different Kinds of Biomarkers Prognostic
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Assays of Genetic Expression in Tumor Tissue as a Technique Page 1 of 54 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Assays of Genetic Expression in Tumor Tissue
More informationAssays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
Medical Policy Manual Genetic Testing, Policy No. 42 Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer Next Review: December 2018 Last Review:
More informationAssays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer Policy Number: 2.04.36 Last Review: 1/2019 Origination: 1/2006 Next Review: 9/2019 Policy
More informationAssays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer Policy Number: 2.04.36 Last Review: 9/2018 Origination: 1/2006 Next Review: 9/2019 Policy
More informationOncotype DX MM /01/2008. HMO; PPO; QUEST 03/01/2014 Section: Other/Miscellaneous Place(s) of Service: Office
Oncotype DX Policy Number: Original Effective Date: MM.12.009 12/01/2008 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST 03/01/2014 Section: Other/Miscellaneous Place(s) of Service: Office
More information38 years old, premenopausal, had L+snbx. Pathology: IDC Gr.II T-1.9cm N+2/4sn ER+100%st, PR+60%st, Her2-neg, KI %
38 years old, premenopausal, had L+snbx Pathology: IDC Gr.II T-1.9cm N+2/4sn ER+100%st, PR+60%st, Her2-neg, KI67 5-10% Question: What will you do now? 1. Give adjuvant chemotherapy 2. Send for Oncotype
More informationEvolving Insights into Adjuvant Chemotherapy. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology
Evolving Insights into Adjuvant Chemotherapy Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology Dilemmas in Adjuvant Chemotherapy Is adjuvant chemotherapy effective in ER+
More informationHarmesh Naik, MD. Hope Cancer Clinic PERSONALIZED CANCER TREATMENT USING LATEST IN MOLECULAR BIOLOGY
Harmesh Naik, MD. Hope Cancer Clinic PERSONALIZED CANCER TREATMENT USING LATEST IN MOLECULAR BIOLOGY A NEW GENE A DAY.WHILE YOU ARE ENJOYING MORNING COFFEE From cancer.gov GOALS FOR THE CME TODAY A brief
More informationAlternate Gene Signatures, or Not
Charles M. Perou, Ph.D. Departments of Genetics and Pathology Lineberger Comprehensive Cancer Center University of North Carolina Chapel Hill, North Carolina, USA Alternate Gene Signatures, or Not Charles
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Assays of Genetic Expression in Tumor Tissue as a Technique Page 1 of 47 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Assays of Genetic Expression in Tumor Tissue
More informationManejo do câncer de mama RH+ na adjuvância: o que há de novo?
II Simpósio Internacional de Câncer de Mama para o Oncologista Clínico Manejo do câncer de mama RH+ na adjuvância: o que há de novo? INGRID A. MAYER, MD, MSCI Assistant Professor of Medicine Director,
More informationEmerging Approaches for (Neo)Adjuvant Therapy for ER+ Breast Cancer
Emerging Approaches for (Neo)Adjuvant Therapy for E+ Breast Cancer Cynthia X. Ma, M.D., Ph.D. Associate Professor of Medicine Washington University in St. Louis Outline Current status of adjuvant endocrine
More informationImmunohistochemical classification of breast tumours
Immunohistochemical classification of breast tumours Workshop in Diagnostic Immunohistochemistry September 19 th - 21 th 2018 Anne-Vibeke Lænkholm Department of Surgical Pathology, Zealand University Hospital,
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,100 116,000 120M Open access books available International authors and editors Downloads Our
More informationSesiones interhospitalarias de cáncer de mama. Revisión bibliográfica 4º trimestre 2015
Sesiones interhospitalarias de cáncer de mama Revisión bibliográfica 4º trimestre 2015 Selected papers Prospective Validation of a 21-Gene Expression Assay in Breast Cancer TAILORx. NEJM 2015 OS for fulvestrant
More informationA Prospective Comparison of the 21-Gene Recurrence Score and the PAM50-Based Prosigna in Estrogen Receptor-Positive Early-Stage Breast Cancer
Adv Ther (2015) 32:1237 1247 DOI 10.1007/s12325-015-0269-2 ORIGINAL RESEARCH A Prospective Comparison of the 21-Gene Recurrence Score and the PAM50-Based Prosigna in Estrogen Receptor-Positive Early-Stage
More informationSection: Genetic Testing Last Reviewed Date: March Policy No: 42 Effective Date: June 1, 2014
Medical Policy Manual Topic: Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis In Patients With Breast Cancer Date of Origin: October 5, 2004 Section: Genetic Testing Last
More informationKey points about expression profile intrinsic subtypes. Analytically robust expression profiles from FFPE sections using Nanostring technology
Analytically robust expression profiles from FFPE sections using Nanostring technology Torsten O. Nielsen, MD/PhD, FRCPC Professor of Pathology and Laboratory Medicine University of British Columbia, Vancouver,
More informationLearning Objectives. Financial Disclosure. Breast Cancer Quality Improvement Project with Oncotype DX. Nothing to disclose
Breast Cancer Quality Improvement Project with Oncotype DX Denise Johnson Miller, MD, FACS Medical Director Breast Surgery Hackensack Meridian Health Legacy Meridian (Jersey Shore University Medical Center,
More informationNew Molecular Classifications of Breast Cancer
New Molecular Classifications of Breast Cancer Mary Cianfrocca, DO 1 and William Gradishar, MD 2 Abstract Traditionally, pathologic determinations of tumor size, lymph node status, endocrine receptor status,
More informationDevelopment and verification of the PAM50-based Prosigna breast cancer gene signature assay
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2015 Development and verification of the PAM50-based Prosigna breast cancer gene signature assay Jacqueline Snider
More informationCarcinome du sein Biologie moléculaire. Thomas McKee Service de Pathologie Clinique Genève
Carcinome du sein Biologie moléculaire Thomas McKee Service de Pathologie Clinique Genève Pathology Diagnostic Prognostic information Predictive information The information provided depends on the available
More informationORMONOTERAPIA ADIUVANTE: QUALE LA DURATA OTTIMALE? MARIANTONIETTA COLOZZA
ORMONOTERAPIA ADIUVANTE: QUALE LA DURATA OTTIMALE? MARIANTONIETTA COLOZZA THE NATURAL HISTORY OF HORMONE RECEPTOR- POSITIVE BREAST CANCER IS VERY LONG Recurrence hazard rate 0.3 0.2 0.1 0 ER+ (n=2,257)
More informationDIAGNOSTICS ASSESSMENT PROGRAMME
DIAGNOSTICS ASSESSMENT PROGRAMME Evidence overview Tumour profiling tests to guide adjuvant chemotherapy decisions in people with breast cancer (update of DG10) This overview summarises the key issues
More informationCARCINOMA DELLA MAMMELLA La scelta del trattamento adiuvante: utilità clinica dei tests genomici
CARCINOMA DELLA MAMMELLA La scelta del trattamento adiuvante: utilità clinica dei tests genomici Dott.ssa Gaia Griguolo DiSCOG-Università di Padova IOV Istituto Oncologico Veneto I.R.C.C.S. Tutor: Prof.
More informationThe Neoadjuvant Model as a Translational Tool for Drug and Biomarker Development in Breast Cancer
The Neoadjuvant Model as a Translational Tool for Drug and Biomarker Development in Breast Cancer Laura Spring, MD Breast Medical Oncology Massachusetts General Hospital Primary Mentor: Dr. Aditya Bardia
More informationCorporate Medical Policy
Corporate Medical Policy Assays of Genetic Expression to Determine Prognosis of Breast File Name: Origination: Last CAP Review: Next CAP Review: Last Review: assays_of_genetic_expression_to_determine_prognosis_of_breast_cancer
More informationLuminal A and B Where are we? (or lost in translation?)
Luminal A and B Where are we? (or lost in translation?) Emiel J. Rutgers The Netherlands Cancer Institute Antoni Van Leeuwenhoek Hospital Amsterdam How to determine adjuvant or neoadjuvant treatment for
More informationMEDICAL POLICY. SUBJECT: GENETIC ASSAY OF TUMOR TISSUE TO DETERMINE PROGNOSIS OF BREAST CANCER (OncotypeDX TM, MammaPrint )
MEDICAL POLICY PAGE: 1 OF: 8 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy criteria are not applied.
More informationType: Evidence Based Evidence Quality: High Strength of Recommendation: Strong
Clinical Question 1: For women with early-stage invasive breast cancer and with known estrogen and progesterone receptor (ER/PgR) and human epidermal growth factor receptor 2 (HER2 status), which other
More informationIntervention(s) Results primary outcome Results secondary and other outcomes
Uitgangsvraag 4: evidence tables Welke nieuwe vormen van risicoprofilering zijn - in tegenstelling tot de traditionele prognostische factoren als tumorgrootte, lymfklierstatus en tumorgradering - van invloed
More informationThe Role of Novel Assays in the Prediction of Benefit from Extended Adjuvant Endocrine Therapy for Breast Cancer
The Role of Novel Assays in the Prediction of Benefit from Extended Adjuvant Endocrine Therapy for Breast Cancer Erin Roesch, MD, and Claudine Isaacs, MD Abstract Endocrine therapy in the adjuvant setting
More informationOnly Estrogen receptor positive is not enough to predict the prognosis of breast cancer
Young Investigator Award, Global Breast Cancer Conference 2018 Only Estrogen receptor positive is not enough to predict the prognosis of breast cancer ㅑ Running head: Revisiting estrogen positive tumors
More informationAssays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana
More information