Case-Based Review and Clinical Guidance on the Use of Genomic Assays for Early-Stage Breast Cancer: Breast Cancer Therapy Expert Group (BCTEG)

Muaiad Kittaneh, Sunil Badve, Humberto Caldera, Robert Coleman, Matthew P. Goetz, Reshma Mahtani, Eleftherios Mamounas, Kevin Kalinsky, Elyse Lower, Mark Pegram, Michael F. Press, Hope S. Rugo, Lee Schwartzberg, Tiffany Traina, Charles Vogel

Research output: Contribution to journalReview article

Abstract

In addition to classical clinicopathologic factors, such as hormone receptor positivity, human epidermal growth factor receptor 2 (HER2) status, and tumor size, grade, and lymph node status, a number of commercially available genomic tests may be used to help inform treatment decisions for early breast cancer patients. Although these tests improve our understanding of breast cancer and help to individualize treatment decisions, clinicians face challenges when deciding on the most appropriate test to order, and the advantages, if any, of one test over another. The Breast Cancer Therapy Expert Group (BCTEG) recently convened a roundtable meeting to discuss issues surrounding the use of genomic testing in early breast cancer, with the goal of providing practical guidance on the use of these tests by the community oncologist, for whom breast cancer may be only one of many tumor types they treat. The group recognizes that genomic testing can provide important prognostic (eg, risk for recurrence), and in some cases predictive, information (eg, benefit of chemotherapy, or extended adjuvant endocrine therapy), which can be used to help guide treatment decisions in breast cancer. The available tests differ in the types of information they provide, and in the patient populations and clinical trials that were conducted to validate them. We summarize the discussion of the BCTEG on this topic, and we also consider several patient cases and clinical scenarios in which genomic testing may, or may not, be useful to guide treatment decisions for the practicing community oncologist.

Original languageEnglish (US)
JournalClinical breast cancer
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • Chemotherapy
  • Extended adjuvant therapy
  • Genomic testing
  • Molecular profiling
  • Recurrence risk

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Kittaneh, M., Badve, S., Caldera, H., Coleman, R., Goetz, M. P., Mahtani, R., Mamounas, E., Kalinsky, K., Lower, E., Pegram, M., Press, M. F., Rugo, H. S., Schwartzberg, L., Traina, T., & Vogel, C. (Accepted/In press). Case-Based Review and Clinical Guidance on the Use of Genomic Assays for Early-Stage Breast Cancer: Breast Cancer Therapy Expert Group (BCTEG). Clinical breast cancer. https://doi.org/10.1016/j.clbc.2020.01.001