ASCO - Breast Cancer Biomarkers Flipbook 2019

Breast Cancer Biomarkers 2019 Update

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Key Points ➤ In an era of great interest in personalized, precision medicine, the role of tumor biomarker assays in guiding clinical care has taken on even greater importance than in the past. ➤ In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2 (HER2), the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX, MammaPrint, EndoPredict, PAM50, Breast Cancer Index, and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer. ➤ No biomarker except for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens. ➤ Treatment decisions should also consider disease stage, comorbidities, and patient preferences. Diagnosis For patients who present with a hormone receptor positive, HER2 not overexpressed, axillary node negative early breast cancer: Oncotype DX ➤ For patients older than 50 and whose tumors have Oncotype DX recurrence scores <26, and for patients ≤50 whose tumors have Oncotype DX recurrence scores <16, there is little to no benefit from chemotherapy. Clinicians may offer endocrine therapy alone. (Strong Recommendation; EB-H) ➤ For patients 50 years of age or younger with Oncotype DX recurrence scores of 16 to 25, clinicians may offer chemoendocrine therapy. (Moderate Recommendation; EB-I) ➤ Patients with Oncotype DX recurrence scores >30 should be considered candidates for chemoendocrine therapy. (Strong Recommendation; EB-H) ➤ Based on Expert Panel consensus, oncologists may offer chemoendocrine therapy to patients with Oncotype DX scores of 26 to 30. (Moderate Recommendation; IC-Ins)

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