Clinical and therapeutic perspectives of gene expression profiling for breast cancer

The standard method for defining prognosis for patients with breast cancer is an integrated model including clinicopathological features, such as tumour size, histological grade, nodal involvement, hormone receptor status and HER-2 overexpression. Nowadays, two multigene prognostic models can stratify patients in new categories of risk. Notably, clinicopathological prognostic prediction and genomic signatures are discordant in at least 30% of cases. For this reason, two trials are going on, aiming to validate clinical utility of gene profiling. As regards the predictive value of genomic assays, many models have been carried out, demonstrating the capacity to identify with high sensitivity and specificity resistant and non-resistant tumours, differently from the traditional markers. These predictors, however, need to be validated by prospective clinical trials.