Biomedical Engineering Reference
In-Depth Information
Chemotherapy
plus targeted
therapy
Targeted
therapy
Biomarker
Chemotherapy
KRAS mutations in
codon 12 or 13
++
MammaPrint Test
++
++
Onco
type
DX assay
++
++
PML/RAR(a) gene
expression
++
+++
TPMT deficiency or
low activity
++
UGT1A1
polymorphisms and
mutation
++
+++, High level of relevance in relation to treatment outcome, which may reflect a
degree of capturing or a linkage to the treatment effect or toxicity; ++, intermediate
level of relevance; + low level of relevance.
1.6
Multi-Gene Expression or Signatures for
Cancer Prognosis and Treatment
Patient and tumor characteristics at diagnosis or at baseline provide
important information about a likely patient outcome and influence
the treatment decisions across many tumor types. However, these
subjects are not extensively discussed in this topic. Some patients
with early breast cancer may be cured with surgery alone or with
surgery plus standard endocrine therapy. The existing guidelines
recommend adjuvant chemotherapy in breast cancer patients
whose tumors are at least 1.0 cm, which has led to the concerns
of overtreatment. A critical question is which patients with early
breast cancer require chemotherapy and which do not. Multi-gene
expression and gene expression signatures such as Oncotype DX and
MammaPrint have been evolved as valid prognostic and predictive
tools of outcome for patients with early stage breast cancer. Onco
type
DX breast cancer test, a 21-gene recurrence score (RS), is an RT-PCR-
based assay that utilizes paraffin-embedded tissue and measures
