Rachel Würstlein, Ronald E. Kates, Oleg Gluz, Eva-Maria Grischke, Christian Schem, Marc Thill, Stephan Hasmüller, Andreas Köhler, Burkhard Otremba, Frank Griesinger, Christian Schindlbeck, Andreas Trojan, Florian Otto, Michael Knauer, Renate Pusch, Nadia Harbeck
- 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.
MetadatenAuthor: | Rachel WürstleinORCiDGND, Ronald E. Kates, Oleg GluzORCiDGND, Eva-Maria GrischkeORCiDGND, Christian Schem, Marc Thill, Stephan Hasmüller, Andreas Köhler, Burkhard Otremba, Frank GriesingerGND, Christian Schindlbeck, Andreas Trojan, Florian Otto, Michael Knauer, Renate Pusch, Nadia HarbeckORCiDGND |
---|
URN: | urn:nbn:de:hebis:30:3-534146 |
---|
DOI: | https://doi.org/10.1007/s10549-018-05075-x |
---|
ISSN: | 1573-7217 |
---|
ISSN: | 0167-6806 |
---|
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/30796651 |
---|
Parent Title (English): | Breast cancer research and treatment |
---|
Publisher: | Springer Science + Business Media B.V. |
---|
Place of publication: | Dordrecht [u. a.] |
---|
Document Type: | Article |
---|
Language: | English |
---|
Year of Completion: | 2019 |
---|
Date of first Publication: | 2019/02/22 |
---|
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
---|
Contributing Corporation: | WSG-PRIMe investigators in Germany, Austria, Switzerland |
---|
Release Date: | 2020/04/27 |
---|
Tag: | BluePrint; Breast cancer; Decision impact; Diagnostic test; MammaPrint; Molecular profiling |
---|
Volume: | 175 |
---|
Page Number: | 11 |
---|
First Page: | 389 |
---|
Last Page: | 399 |
---|
Note: | 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. |
---|
HeBIS-PPN: | 465941680 |
---|
Institutes: | Medizin / Medizin |
---|
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
---|
Sammlungen: | Universitätspublikationen |
---|
Licence (German): | Creative Commons - Namensnennung 4.0 |
---|