In a nutshell
This paper looks at the use of a system called EPclin that gives patients a risk score according to the clinical and genetic characteristics of their tumor. This score is used to predict if patients are at high or low risk of distant reccurrence of the tumor and if they would benefit from chemotherapy.
Some background
Treatment of early breast cancer is based not only on its location but also on its physical and genetic characteristics. This includes if the cancer responds to estrogen (ER-positive), or if the cancer cells produces larger quantities of a protein called HER-2 (HER-2 positive). Patients who have breast cancers with these characteristics benefit greatly from endocrine treatment such as tamoxifen which blocks the estrogen receptors needed for tumor growth. However, the benefit of chemotherapy in these patients with early breast cancer is not fully understood.
Methods & findings
This paper investigates the use of a grading system that gives patients a score in relation to the risk of distant cancer reccurrence based on genetic characteristics of the tumor. A system like this would allow choosing lines of treatment more easily. For example, if the patient was scored as being at high risk of having a metastatic or distant recurrence of the cancer, then they may feel that treatment with chemotherapy was worth the side effects it may give. Patients who are only at low risk of recurrence may not want to receive this treatment.
1702 postmenopausal women with ER positive and HER-2 negative breast cancers were included in this study. They were assigned risk scores based on three current sets of clinical guidelines. These risk scores were called the EPclin score and involved both clinical and molecular considerations.
Overall, 58-61% of women previously assigned an intermediate or high risk score of distant reccurrence were reassigned a new low-risk using the EPclin score.
The bottom line
In women with ER-positive, HER-2 negative breast cancer, the use of EPclin could help better identify cases that will benefit from chemotherapy.
What’s next?
Talk to your doctor about the possibility of calculating your EPclin score.
Published By :
Annals of oncology
Date :
Oct 03, 2012
