Recommendations from the European Commission Initiative on Breast Cancer for multigene testing to guide the use of adjuvant chemotherapy in patients with early breast cancer, hormone receptor positive, HER-2 negative

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  • dc.contributor.author Giorgi Rossi, Paolo
  • dc.contributor.author Lebeau, Annette
  • dc.contributor.author Canelo Aybar, Carlos
  • dc.contributor.author Saz Parkinson, Zuleika
  • dc.contributor.author Quinn, Cecily
  • dc.contributor.author Langendam, Miranda
  • dc.contributor.author Mcgarrigle, Helen
  • dc.contributor.author Warman, Sue
  • dc.contributor.author Rigau, David
  • dc.contributor.author Alonso Coello, Pablo
  • dc.contributor.author Broeders, Mireille
  • dc.contributor.author Graewingholt, Axel
  • dc.contributor.author Posso, Margarita
  • dc.contributor.author Duffy, Stephen
  • dc.contributor.author Schünemann, Holger J.
  • dc.contributor.author ECIBC Contributor Group
  • dc.date.accessioned 2021-04-21T08:06:28Z
  • dc.date.available 2021-04-21T08:06:28Z
  • dc.date.issued 2021
  • dc.description.abstract Background: Predicting the risk of recurrence and response to chemotherapy in women with early breast cancer is crucial to optimise adjuvant treatment. Despite the common practice of using multigene tests to predict recurrence, existing recommendations are inconsistent. Our aim was to formulate healthcare recommendations for the question "Should multigene tests be used in women who have early invasive breast cancer, hormone receptor-positive, HER2-negative, to guide the use of adjuvant chemotherapy?". Methods: The European Commission Initiative on Breast Cancer (ECIBC) Guidelines Development Group (GDG), a multidisciplinary guideline panel including experts and three patients, developed recommendations informed by systematic reviews of the evidence. Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision frameworks were used. Four multigene tests were evaluated: the 21-gene recurrence score (21-RS), the 70-gene signature (70-GS), the PAM50 risk of recurrence score (PAM50-RORS), and the 12-gene molecular score (12-MS). Results: Five studies (2 marker-based design RCTs, two treatment interaction design RCTs and 1 pooled individual data analysis from observational studies) were included; no eligible studies on PAM50-RORS or 12-MS were identified and the GDG did not formulate recommendations for these tests. Conclusions: The ECIBC GDG suggests the use of the 21-RS for lymph node-negative women (conditional recommendation, very low certainty of evidence), recognising that benefits are probably larger in women at high risk of recurrence based on clinical characteristics. The ECIBC GDG suggests the use of the 70-GS for women at high clinical risk (conditional recommendation, low certainty of evidence), and recommends not using 70-GS in women at low clinical risk (strong recommendation, low certainty of evidence).
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Giorgi Rossi P, Lebeau A, Canelo-Aybar C, Saz-Parkinson Z, Quinn C, Langendam M, Mcgarrigle H, Warman S, Rigau D, Alonso-Coello P, Broeders M, Graewingholt A, Posso M, Duffy S, Schünemann HJ; ECIBC Contributor Group. Recommendations from the European Commission Initiative on Breast Cancer for multigene testing to guide the use of adjuvant chemotherapy in patients with early breast cancer, hormone receptor positive, HER-2 negative. Br J Cancer. 2021;124:1503-12. DOI: 10.1038/s41416-020-01247-z
  • dc.identifier.doi http://dx.doi.org/10.1038/s41416-020-01247-z
  • dc.identifier.issn 0007-0920
  • dc.identifier.uri http://hdl.handle.net/10230/47173
  • dc.language.iso eng
  • dc.publisher Nature Research
  • dc.relation.ispartof Br J Cancer. 2021;124:1503-12
  • dc.rights © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Breast cancer
  • dc.subject.keyword Prognostic markers
  • dc.title Recommendations from the European Commission Initiative on Breast Cancer for multigene testing to guide the use of adjuvant chemotherapy in patients with early breast cancer, hormone receptor positive, HER-2 negative
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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