TY  - JOUR
A1  - Würstlein, Rachel
A1  - Kates, Ronald E.
A1  - Gluz, Oleg
A1  - Grischke, Eva-Maria
A1  - Schem, Christian
A1  - Thill, Marc
A1  - Hasmüller, Stephan
A1  - Köhler, Andreas
A1  - Otremba, Burkhard
A1  - Griesinger, Frank
A1  - Schindlbeck, Christian
A1  - Trojan, Andreas
A1  - Otto, Florian
A1  - Knauer, Michael
A1  - Pusch, Renate
A1  - Harbeck, Nadia
T1  - Strong impact of MammaPrint and BluePrint on treatment decisions in luminal early breast cancer: results of the WSG-PRIMe study
T2  - Breast cancer research and treatment
N2  - Purpose: The WSG-PRIMe Study prospectively evaluated the impact of the 70-gene signature MammaPrint® (MP) and the 80-gene molecular subtyping assay BluePrint® on clinical therapy decisions in luminal early breast cancer.
Methods: 452 hormone receptor (HR)-positive and HER2-negative patients were recruited (N0, N1). Physicians provided initial therapy recommendations based on clinicopathological factors. After prospective risk classification by MammaPrint/BluePrint was revealed, post-test treatment recommendations and actual treatment were recorded. Decisional Conflict and anxiety were measured by questionnaires.
Results: Post-test switch (in chemotherapy (CT) recommendation) occurred in 29.1% of cases. Overall, physician adherence to MP risk assessment was 92.3% for low-risk and 94.3% for high-risk MP scores. Adherence was remarkably high in “discordant” groups: 74.7% of physicians initially recommending CT switched to CT omission following low-risk MP scores; conversely, 88.9% of physicians initially recommending CT omission switched to CT recommendations following high-risk MP scores. Most patients (99.2%) recommended to forgo CT post-test and 21.3% of patients with post-test CT recommendations did not undergo CT; among MP low-risk patients with pre-test and post-test CT recommendations, 40% did not actually undergo CT. Luminal subtype assessment by BluePrint was discordant with IHC assessment in 34% of patients. Patients’ State Anxiety scores improved significantly overall, particularly in MP low-risk patients. Trait Anxiety scores increased slightly in MP high risk and decreased slightly in MP low-risk patients.
Conclusions: MammaPrint and BluePrint test results strongly impacted physicians’ therapy decisions in luminal EBC with up to three involved lymph nodes. The high adherence to genetically determined risk assessment represents a key prerequisite for achieving a personalized cost-effective approach to disease management of early breast cancer.
KW  - Breast cancer
KW  - Diagnostic test
KW  - MammaPrint
KW  - BluePrint
KW  - Molecular profiling
KW  - Decision impact
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/53414
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-534146
SN  - 1573-7217
SN  - 0167-6806
N1  - Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
VL  - 175
SP  - 389
EP  - 399
PB  - Springer Science + Business Media B.V.
CY  - Dordrecht [u. a.]
ER  -