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Open Access 01-10-2019 | Breast Cancer | Breast Oncology

The Changing Role of Gene-Expression Profiling in the Era of De-escalating Adjuvant Chemotherapy in Early-Stage Breast Cancer

Authors: J. E. C. van Steenhoven, MD, A. Kuijer, MD, PhD, K. Schreuder, PhD, S. G. Elias, MD, PhD, P. J. van Diest, MD, PhD, E. van der Wall, MD, PhD, S. Siesling, PhD, T. van Dalen, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2019

Abstract

Purpose

We assessed the recent trends in the administration of adjuvant chemotherapy thereby evaluating the role of the 70-gene signature (70-GS) testing in decision-making in the systemic treatment of patients with lymph node negative (N0) and lymph node positive (N+) breast cancer.

Methods

Patients with a national guideline directed indication for 70-GS use treated between 2013 and 2016 were selected from the Netherlands Cancer Registry. Time trends in the administration of adjuvant chemotherapy were evaluated within guideline- and age-delineated subgroups. The influence of the 70-GS on chemotherapy use was assessed with logistic regression.

Results

During the study period, the overall administration of adjuvant chemotherapy decreased from 49 to 23% and 70-GS use increased from 24 to 51%. The 70-GS was not associated with a decreased likelihood for N0 patients to receive chemotherapy (odds ratio [OR] 1.0; 95% confidence interval [CI] 0.86–1.17), as the proportion of N0 patients who received chemotherapy in the absence of 70-GS use decreased during the study period. In patients with N1a disease, 70-GS testing was associated with a decreased likelihood to receive chemotherapy (OR 0.21; 95% CI 0.15–0.29). In patients < 50 years and 50–59 years of age, 70-GS use was associated with a consistent lower proportion of patients receiving chemotherapy throughout the study period (OR 0.17; 95% CI 0.13–0.23 and OR 0.53; 95% CI 0.43–0.65, respectively).

Conclusions

In this population-based study, the administration of adjuvant chemotherapy in ER+ breast cancer strongly declined. For node-positive and younger patients, 70-GS use was associated with a decreased probability for patients to receive adjuvant chemotherapy.

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Title: The Changing Role of Gene-Expression Profiling in the Era of De-escalating Adjuvant Chemotherapy in Early-Stage Breast Cancer
Authors: J. E. C. van Steenhoven, MD
A. Kuijer, MD, PhD
K. Schreuder, PhD
S. G. Elias, MD, PhD
P. J. van Diest, MD, PhD
E. van der Wall, MD, PhD
S. Siesling, PhD
T. van Dalen, MD, PhD
Publication date: 01-10-2019
Publisher: Springer International Publishing
Keywords: Breast Cancer
Breast Cancer
Cytostatic Therapy
Published in: Annals of Surgical Oncology / Issue 11/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-019-07511-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Changing Role of Gene-Expression Profiling in the Era of De-escalating Adjuvant Chemotherapy in Early-Stage Breast Cancer

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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