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Open Access 25-10-2023 | Breast Cancer | Review

Biomarkers predictive of a response to extended endocrine therapy in breast cancer: a systematic review and meta-analysis

Authors: Kirsten M. Woolpert, Thomas P. Ahern, Timothy L. Lash, Donna L. O’Malley, Alice M. Stokes, Deirdre P. Cronin-Fenton

Published in: Breast Cancer Research and Treatment | Issue 3/2024

Abstract

Purpose

Extension of adjuvant endocrine therapy beyond five years confers only modest survival benefit in breast cancer patients and carries risk of toxicities. This systematic review investigates the role of biomarker tests in predicting the clinical response to an extension of endocrine therapy.

Methods

We searched Ovid MEDLINE, Ovid Embase, Global Index Medicus, and the Cochrane Central Register of Controlled Trials using an iterative approach to identify full-text articles related to breast cancer, endocrine therapy, and biomarkers.

Results

Of the 1,217 unique reports identified, five studies were deemed eligible. Four investigated the Breast Cancer Index (BCI) assay in three distinct study populations. These studies consistently showed that BCI score was predictive of response to extended endocrine therapy among 1,946 combined patients, who were predominately non-Hispanic white and postmenopausal.

Conclusions

Evidence in the setting of predictive tests for extended endocrine therapy is sparse. Most relevant studies investigated the use of BCI, but these study populations were largely restricted to a single age, race, and ethnicity group. Future studies should evaluate a variety of biomarkers in diverse populations. Without sufficient evidence, physicians and patients face a difficult decision in balancing the benefits and risks of endocrine therapy extension.

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Title: Biomarkers predictive of a response to extended endocrine therapy in breast cancer: a systematic review and meta-analysis
Authors: Kirsten M. Woolpert
Thomas P. Ahern
Timothy L. Lash
Donna L. O’Malley
Alice M. Stokes
Deirdre P. Cronin-Fenton
Publication date: 25-10-2023
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Biomarkers
Tamoxifen
Letrozole
Published in: Breast Cancer Research and Treatment / Issue 3/2024
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-023-07149-x

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