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Real World Evaluation of the Prosigna/PAM50 Test in a Node-Negative Postmenopausal Swedish Population : A Multicenter Study

Kjällquist, Una ; Acs, Balazs ; Margolin, Sara ; Karlsson, Emelie ; Kessler, Luisa Edman ; Hernandez, Scarlett Garcia ; Ekholm, Maria ; Lundgren, Christine LU ; Olsson, Erik and Lindman, Henrik , et al. (2022) In Cancers 14(11).
Abstract

Molecular signatures to guide decisions for adjuvant chemotherapy are recommended in early ER-positive, HER2-negative breast cancer. The objective of this study was to assess what impact gene-expression-based risk testing has had following its recommendation by Swedish national guidelines. Postmenopausal women with ER-positive, HER2-negative and node negative breast cancer at intermediate clinical risk and eligible for chemotherapy were identified retrospectively from five Swedish hospitals. Tumor characteristics, results from Prosigna® test and final treatment decision were available for all patients. Treatment recommendations were compared with the last version of regional guidelines before the introduction of routine risk signature... (More)

Molecular signatures to guide decisions for adjuvant chemotherapy are recommended in early ER-positive, HER2-negative breast cancer. The objective of this study was to assess what impact gene-expression-based risk testing has had following its recommendation by Swedish national guidelines. Postmenopausal women with ER-positive, HER2-negative and node negative breast cancer at intermediate clinical risk and eligible for chemotherapy were identified retrospectively from five Swedish hospitals. Tumor characteristics, results from Prosigna® test and final treatment decision were available for all patients. Treatment recommendations were compared with the last version of regional guidelines before the introduction of routine risk signature testing. Among the 360 included patients, 41% (n = 148) had a change in decision for adjuvant treatment based on Prosigna® test result. Out of the patients with clinical indication for adjuvant chemotherapy, 52% (n = 118) could avoid treatment based on results from Prosigna® test. On the contrary, 23% (n = 30) of the patients with no indication were escalated to receive adjuvant chemotherapy after testing. Ki67 could not distinguish between the Prosigna® risk groups or intrinsic subtypes and did not significantly differ between patients in which decision for adjuvant therapy was changed based on the test results. In conclusion, we report the first real-world data from implementation of gene-expression-based risk assessment in a Swedish context, which may facilitate the optimization of future versions of the national guidelines.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adjuvant chemotherapy, breast cancer, gene expression profiling, gene expression signature, impact, PAM50, Prosigna
in
Cancers
volume
14
issue
11
article number
2615
publisher
MDPI AG
external identifiers
  • scopus:85131003430
  • pmid:35681597
ISSN
2072-6694
DOI
10.3390/cancers14112615
language
English
LU publication?
yes
id
2342e467-d11e-4eb4-8a53-119e8a6f5d84
date added to LUP
2023-01-04 12:45:42
date last changed
2024-09-07 06:02:43
@article{2342e467-d11e-4eb4-8a53-119e8a6f5d84,
  abstract     = {{<p>Molecular signatures to guide decisions for adjuvant chemotherapy are recommended in early ER-positive, HER2-negative breast cancer. The objective of this study was to assess what impact gene-expression-based risk testing has had following its recommendation by Swedish national guidelines. Postmenopausal women with ER-positive, HER2-negative and node negative breast cancer at intermediate clinical risk and eligible for chemotherapy were identified retrospectively from five Swedish hospitals. Tumor characteristics, results from Prosigna® test and final treatment decision were available for all patients. Treatment recommendations were compared with the last version of regional guidelines before the introduction of routine risk signature testing. Among the 360 included patients, 41% (n = 148) had a change in decision for adjuvant treatment based on Prosigna® test result. Out of the patients with clinical indication for adjuvant chemotherapy, 52% (n = 118) could avoid treatment based on results from Prosigna® test. On the contrary, 23% (n = 30) of the patients with no indication were escalated to receive adjuvant chemotherapy after testing. Ki67 could not distinguish between the Prosigna® risk groups or intrinsic subtypes and did not significantly differ between patients in which decision for adjuvant therapy was changed based on the test results. In conclusion, we report the first real-world data from implementation of gene-expression-based risk assessment in a Swedish context, which may facilitate the optimization of future versions of the national guidelines.</p>}},
  author       = {{Kjällquist, Una and Acs, Balazs and Margolin, Sara and Karlsson, Emelie and Kessler, Luisa Edman and Hernandez, Scarlett Garcia and Ekholm, Maria and Lundgren, Christine and Olsson, Erik and Lindman, Henrik and Foukakis, Theodoros and Matikas, Alexios and Hartman, Johan}},
  issn         = {{2072-6694}},
  keywords     = {{adjuvant chemotherapy; breast cancer; gene expression profiling; gene expression signature; impact; PAM50; Prosigna}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{11}},
  publisher    = {{MDPI AG}},
  series       = {{Cancers}},
  title        = {{Real World Evaluation of the Prosigna/PAM50 Test in a Node-Negative Postmenopausal Swedish Population : A Multicenter Study}},
  url          = {{http://dx.doi.org/10.3390/cancers14112615}},
  doi          = {{10.3390/cancers14112615}},
  volume       = {{14}},
  year         = {{2022}},
}