|Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.||
Gene-expression profiles to predict distant metastasis of lymph-node-negative primary breast cancer
Researchers in this study hoped to use “genome-wide measures of gene expression” to “identify patterns of gene activity that [can] subclassify tumours” and hopefully provide clinicians with better ability to target specific treatments in patients with lymph-node-negative breast cancer. The researchers used Affymetrix Human U133a GeneChips, to analyze “the expression of 22,000 transcripts from total RNA of frozen tumour samples from 286 lymph-node-negative patients who had not received adjuvant systemic treatment.
They found that “in a training set of 115 tumours” they were able to identify “a 76-gene signature consisting of 60 genes for patients positive for oestrogen receptors (ER) and 16 genes for ER-negative patients. This signature showed 93% sensitivity and 48% specificity in a subsequent independent testing set of 171 lymph-node-negative patients. The gene profile was highly informative in identifying patients who developed distant metastases within 5 years…even when corrected for traditional prognostic factors in multivariate analysis. The 76-gene profile also represented a strong prognostic factor for the development of metastasis in the subgroups of 84 premenopausal patients..87 postmenopausal patients…and 79 patients with tumours of 10-20 mm…a group of patients for whom prediction of prognosis is especially difficult.”
They conclude that “the identified [gene] signature provides a powerful tool for identification of patients at high risk of distant [tumor] recurrence. The ability to identify patients who have a favourable prognosis could, after independent confirmation, allow clinicians to avoid adjuvant systemic therapy or to choose less aggressive therapeutic options.”
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