The Prognostic and Predictive Value of Genomic Assays in Guiding Adjuvant Breast Radiation Therapy

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2023 Jan 21

PMID 36672606

Authors

Sasha J Beyer

Miranda Tallman

Sachin R Jhawar

Julia R White

Jose G Bazan

Affiliations

Soon will be listed here.

Abstract

Many patients with non-metastatic breast cancer benefit from adjuvant radiation therapy after lumpectomy or mastectomy on the basis of many randomized trials. However, there are many patients that have such low risks of recurrence after surgery that de-intensification of therapy by either reducing the treatment volume or omitting radiation altogether may be appropriate options. On the other hand, dose intensification may be necessary for more aggressive breast cancers. Until recently, these treatment decisions were based solely on clinicopathologic factors. Here, we review the current literature on the role of genomic assays as prognostic and/or predictive biomarkers to help guide adjuvant radiation therapy decision-making.

Citing Articles

Individualising radiation therapy decisions in breast cancer patients based on tumour infiltrating lymphocytes and genomic biomarkers.

Machiels M, Oulkadi R, Tramm T, Stecklein S, Somaiah N, De Caluwe A Breast. 2023; 71:13-21.

PMID: 37437386 PMC: 10512095. DOI: 10.1016/j.breast.2023.06.010.

References

Mamounas E, Liu Q, Paik S, Baehner F, Tang G, Jeong J . 21-Gene Recurrence Score and Locoregional Recurrence in Node-Positive/ER-Positive Breast Cancer Treated With Chemo-Endocrine Therapy. J Natl Cancer Inst. 2017; 109(4). PMC: 5721938. DOI: 10.1093/jnci/djw259. View

Bane A, Whelan T, Pond G, Parpia S, Gohla G, Fyles A . Tumor factors predictive of response to hypofractionated radiotherapy in a randomized trial following breast conserving therapy. Ann Oncol. 2014; 25(5):992-8. DOI: 10.1093/annonc/mdu090. View

Bazan J, Jhawar S, Stover D, Park K, Beyer S, Healy E . De-escalation of radiation therapy in patients with stage I, node-negative, HER2-positive breast cancer. NPJ Breast Cancer. 2021; 7(1):33. PMC: 7994398. DOI: 10.1038/s41523-021-00242-8. View

Speers C, Zhao S, Liu M, Bartelink H, Pierce L, Feng F . Development and Validation of a Novel Radiosensitivity Signature in Human Breast Cancer. Clin Cancer Res. 2015; 21(16):3667-77. DOI: 10.1158/1078-0432.CCR-14-2898. View

Woodward W, Barlow W, Jagsi R, Buchholz T, Shak S, Baehner F . Association Between 21-Gene Assay Recurrence Score and Locoregional Recurrence Rates in Patients With Node-Positive Breast Cancer. JAMA Oncol. 2020; 6(4):505-511. PMC: 6990911. DOI: 10.1001/jamaoncol.2019.5559. View

Jayasekera J, Schechter C, Sparano J, Jagsi R, White J, Chapman J . Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer. J Natl Cancer Inst. 2018; 110(12):1370-1379. PMC: 6292790. DOI: 10.1093/jnci/djy128. View

Fisher E, Anderson S, Tan-Chiu E, Fisher B, Eaton L, Wolmark N . Fifteen-year prognostic discriminants for invasive breast carcinoma: National Surgical Adjuvant Breast and Bowel Project Protocol-06. Cancer. 2001; 91(8 Suppl):1679-87. View

Paik S, Shak S, Tang G, Kim C, Baker J, Cronin M . A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004; 351(27):2817-26. DOI: 10.1056/NEJMoa041588. View

Sjostrom M, Chang S, Fishbane N, Davicioni E, Zhao S, Hartman L . Clinicogenomic Radiotherapy Classifier Predicting the Need for Intensified Locoregional Treatment After Breast-Conserving Surgery for Early-Stage Breast Cancer. J Clin Oncol. 2019; 37(35):3340-3349. PMC: 6901281. DOI: 10.1200/JCO.19.00761. View

10.

Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M . Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011; 378(9804):1707-16. PMC: 3254252. DOI: 10.1016/S0140-6736(11)61629-2. View

11.

Shen J, Yan D, Bai L, Geng R, Zhao X, Li H . An 11-Gene Signature Based on Treatment Responsiveness Predicts Radiation Therapy Survival Benefit Among Breast Cancer Patients. Front Oncol. 2022; 11:816053. PMC: 8770413. DOI: 10.3389/fonc.2021.816053. View

12.

He L, Lv Y, Song Y, Zhang B . The prognosis comparison of different molecular subtypes of breast tumors after radiotherapy and the intrinsic reasons for their distinct radiosensitivity. Cancer Manag Res. 2019; 11:5765-5775. PMC: 6612049. DOI: 10.2147/CMAR.S213663. View

13.

Andre F, Ismaila N, Allison K, Barlow W, Collyar D, Damodaran S . Biomarkers for Adjuvant Endocrine and Chemotherapy in Early-Stage Breast Cancer: ASCO Guideline Update. J Clin Oncol. 2022; 40(16):1816-1837. DOI: 10.1200/JCO.22.00069. View

14.

Harris L, Fritsche H, Mennel R, Norton L, Ravdin P, Taube S . American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol. 2007; 25(33):5287-312. DOI: 10.1200/JCO.2007.14.2364. View

15.

Sorlie T, Tibshirani R, Parker J, Hastie T, Marron J, Nobel A . Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci U S A. 2003; 100(14):8418-23. PMC: 166244. DOI: 10.1073/pnas.0932692100. View

16.

Litiere S, Werutsky G, Fentiman I, Rutgers E, Christiaens M, Van Limbergen E . Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol. 2012; 13(4):412-9. DOI: 10.1016/S1470-2045(12)70042-6. View

17.

Lopes Cardozo J, Drukker C, Rutgers E, Schmidt M, Glas A, Witteveen A . Outcome of Patients With an Ultralow-Risk 70-Gene Signature in the MINDACT Trial. J Clin Oncol. 2022; 40(12):1335-1345. DOI: 10.1200/JCO.21.02019. View

18.

Brunt A, Haviland J, Sydenham M, Agrawal R, Algurafi H, Alhasso A . Ten-Year Results of FAST: A Randomized Controlled Trial of 5-Fraction Whole-Breast Radiotherapy for Early Breast Cancer. J Clin Oncol. 2020; 38(28):3261-3272. PMC: 7526720. DOI: 10.1200/JCO.19.02750. View

19.

Eschrich S, Fulp W, Pawitan Y, Foekens J, Smid M, Martens J . Validation of a radiosensitivity molecular signature in breast cancer. Clin Cancer Res. 2012; 18(18):5134-43. PMC: 3993974. DOI: 10.1158/1078-0432.CCR-12-0891. View

20.

Nimeus-Malmstrom E, Krogh M, Malmstrom P, Strand C, Fredriksson I, Karlsson P . Gene expression profiling in primary breast cancer distinguishes patients developing local recurrence after breast-conservation surgery, with or without postoperative radiotherapy. Breast Cancer Res. 2008; 10(2):R34. PMC: 2397536. DOI: 10.1186/bcr1997. View