New gene/tumor tests?


Question from Cheryl58: Are new gene/tumor tests being developed, such as the Oncotype test, that will allow use of a broader range of targeted therapies for use on all tumors (besides ER/PR+)?
Answers - Andrew D. Seidman, M.D. Yes, this is an excellent question and while we've spent most of this chat focusing on targeted therapies and drugs, the other side of the coin is to use diagnostic tests and molecular analysis of specific tumors to enrich the population of patients who will benefit from a given treatment even before one chooses to use the treatment. The Oncotype DX is one such tool. This is a test that is performed on the primary breast tumor and it examines 21 key genes that play an important role in breast cancer metastasis. This test, which is commercially available, provides the patient and her physician with a "recurrence score" which can provide a more accurate and refined estimate of her chance to be cured when diagnosed with early stage breast cancer. Specifically, studies have shown that for patients with lymph node-negative, ER-positive breast cancer, a low recurrence score argues strongly against the use of chemotherapy and a high recurrence score argues strongly in favor of the need for chemotherapy. A large national randomized trial known as TAILORx is getting underway to better determine whether patients whose tumors are characterized as "intermediate risk" based on this Oncotype DX assay will benefit from chemotherapy, or whether perhaps they may be best served by the use of hormonal therapy alone. Thus my long-winded answer to your very direct, specific question is that indeed, tests that analyze tumors well beyond the usual suspects of ER, PR, and HER2 are already beginning to impact our therapeutic approach to breast cancer.
Jennifer Armstrong, M.D. While I am not aware of specific new assays under development, this general area of research is often referred to as genomic or proteomic research, and is an active area of research. Stay tuned!

On Wednesday, July 19, 2006, our Ask-the-Expert Online Conference was called Targeted Therapies: What is Right for You?Andrew Seidman, M.D. and moderatorĀ Jennifer Armstrong, M.D. answered your questions about different kinds of targeted therapies and how they work.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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