Genomic profiling in luminal breast cancer

Area of Science:

• Genomics
• Oncology
• Molecular Biology

Background:

• Gene expression analysis enables sub-classification of hormone receptor-positive (luminal) breast cancer into distinct prognostic subgroups.
• Current clinical practice utilizes prognostic signatures like the 21-gene Oncotype DX® and 70-gene Mammaprint® for luminal breast cancer sub-classification.
• The optimal method for this sub-classification remains undefined, with a lack of evidence from prospective clinical trials.

Purpose of the Study:

• To critically appraise widely used genomic signatures in luminal breast cancer.
• To review and evaluate evidence from retrospective and prospective trials regarding these genomic signatures.
• To address the current gap in understanding the optimal method for luminal breast cancer sub-classification.

Main Methods:

• Systematic literature search using Medline (accessed September 2013).
• Inclusion of abstracts from major oncology conferences: Annual Meeting of American Society of Clinical Oncology and San Antonio Breast Cancer Symposium.
• Critical appraisal of evidence supporting genomic signatures in luminal breast cancer.

Main Results:

• Identified widely used genomic signatures for luminal breast cancer sub-classification.
• Evaluated the existing evidence base, highlighting limitations and gaps.
• The review underscores the absence of definitive prospective trial data for optimal signature selection.

Conclusions:

• Genomic signatures offer prognostic sub-classification for luminal breast cancer.
• Further prospective trials are needed to establish the optimal genomic signature for clinical use.
• Current evidence necessitates careful consideration when applying genomic signatures in routine practice.