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Decision of Adjuvant Systemic Treatment in HR+ HER2- Early Invasive Breast Cancer: Which Biomarkers Could Help?

Authors Alexandre M, Maran-Gonzalez A, Viala M, Firmin N, D'Hondt V, Gutowski M, Bourgier C, Jacot W, Guiu S

Received 2 July 2019

Accepted for publication 21 September 2019

Published 11 December 2019 Volume 2019:11 Pages 10353—10373

DOI https://doi.org/10.2147/CMAR.S221676

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Eileen O'Reilly


Marie Alexandre,1 Aurélie Maran-Gonzalez,2 Marie Viala,1 Nelly Firmin,1 Véronique D’Hondt,1,3,4 Marian Gutowski,5 Céline Bourgier,3,6 William Jacot,1,3,4 Séverine Guiu1,3,4

1Department of Medical Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 2Department of Pathology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 3INSERM U1194 – Institut de Recherche en Cancérologie de Montpellier (IRCM), Montpellier, France; 4University of Montpellier, Montpellier,France; 5Department of Surgery, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 6Department of Radiation Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France

Correspondence: Marie Alexandre
Medical Oncology Department, Institut Régional du Cancer Montpellier, 208, Rue des Apothicaires, Montpellier Cedex 5 34298, France
Tel +33-4 67 61 23 93
Fax +33-4 67 61 37 64
Email marie.alexandre@icm.unicancer.fr

Abstract: The decision to administer adjuvant chemotherapy in treatment of early invasive breast cancer (EBC) is often complex, particularly for hormone receptor-positive (HR+) diseases, and current guidelines often classify these patients in an intermediate-risk group. Several biomarkers are currently available in this indication, in order to obtain additional and more accurate prognostic information compared to classic clinicopathological characteristics and guide the indication of adjuvant chemotherapy, optimizing the efficacy/toxicity ratio. We conducted a systematic review to evaluate the clinical validity and clinical utility of five biomarkers (uPA/PAI-1, OncotypeDX®, MammaPrint®, PAM50, and EndoPredict®) in HR+/HER2- EBC, whatever the nodal status. A total of 89 studies met the inclusion criteria. Even though data currently available confirm the clinical validity of these biomarkers, there is a lack of data regarding clinical utility for most of them. Prospective studies in well-defined populations are needed to integrate these biomarkers in a decision strategy.

Keywords: breast cancer, adjuvant chemotherapy, biomarkers

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