Open AccessCommercially Available Gene Expression Assays as Predictive Tools for Adjuvant Radiotherapy? A Critical Review
Author(s) -
David Krug,
René Baumann,
Wilfried Budach,
Marciaona Duma,
Jürgen Dunst,
Petra Feyer,
Rainer Fietkau,
Wulf Haase,
Wolfgang Harms,
Thomas Hehr,
Marc D. Piroth,
Felix Sedlmayer,
Rainer Souchon,
Frederik Wenz,
Rolf Sauer
Publication year - 2020
Publication title -
breast care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.767
H-Index - 30
eISSN - 1661-3805
pISSN - 1661-3791
DOI - 10.1159/000505656
Subject(s) - medicine , radiation therapy , adjuvant , adjuvant radiotherapy , oncology , clinical trial , predictive value , breast cancer , predictive marker , bioinformatics , cancer , biology
Background: Gene expression assays are increasingly used for decision-making regarding adjuvant chemotherapy in patients with hormone receptor-positive, HER2-negative breast cancer. There are some clinical situations in which there is also a need for better prognostic and predictive markers to better estimate the amount of benefit from adjuvant radiotherapy. The rising availability of gene expression analyses prompts the question whether their results can also be used to guide clinical decisions regarding adjuvant radiation. Summary: Multiple studies suggest a correlation between results from gene expression assays and locoregional recurrence rates. Only few publications addressed the predictive value of results from gene expression analysis for the role of adjuvant radiotherapy in different settings. Key Messages: To date, the available evidence on the possible predictive value of gene expression assays for radiotherapy does not support their inclusion into the decision-making process for adjuvant radiation. This is due to methodological weaknesses and limitations regarding patient selection, the nonrandomized design of all studies in terms of radiotherapy use, and limited availability of tissue from prospective trials. Thus, utilization of the present knowledge for clinical indication of radiotherapy should be very cautious.