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Targeted RNA Sequencing Assay to Characterize Gene Expression and Genomic Alterations
Published on: August 4, 2016
Determining personalized treatment by gene expression profiling in metastatic breast carcinoma patients: a pilot
M Sureda1,2, J Rebollo3, E Mª Martínez-Navarro4,5
1Plataforma de Oncología-Fundación TEDECA, Hospital Quironsalud Torrevieja, Partida de la Loma s/n, 03184, Torrevieja, Alicante, Spain. manuel.sureda@quironsalud.es.
Purpose:
The present study evaluates the massive study of gene expression in metastatic breast carcinoma (MBC) patients using microarray gene expression profiling (MAGE) complemented with conventional sequencing, immunohistochemistry (IHC) and fluorescent "in situ" hybridization (FISH), seeking to optimize the treatment in a subset of heavily pretreated patients and with limited life expectancy.
Patients, Material And Methods:
MBC patients in hormone therapy progression with survival expectancy of at least 3 months (m) have been included. The MAGE contains gene probes representing genes known to potentially interact with available drugs as cited in the literature.
Results:
Thirty-nine procedures were performed from October 2010 to April 2016. Within the 30 evaluable procedures, considering all hormonal manipulations as a single line, the patients had received a median of 4 treatment lines prior to MAGE (range 1-7). Progression was observed in 6 cases, stable disease (SD) in 7 cases and partial response (PR) in 16 cases, which implies a clinical benefit rate (SD + PR) of 76%. Actuarial median progression-free survival (PFS) was 6 m (95% CI 2.5-9.5) in patients with clinical benefit. The median overall survival (OS) for the entire series was 11 m (95% CI 2.2-19.8).
Conclusion:
Data presented here indicate that the use of MAGE provides relevant information to establish personalized treatment in frail patients with limited life expectancy in which therapeutic futility is a particularly difficult burden to assume.
Insights
Microarray gene expression profiling (MAGE) helps personalize treatment for metastatic breast carcinoma patients. This approach offers clinical benefit in heavily pretreated individuals with limited life expectancy.
Area of Science:
- Oncology
- Genomics
- Translational Medicine
Background:
- Metastatic breast carcinoma (MBC) presents significant treatment challenges, particularly in heavily pretreated patients with limited life expectancy.
- Optimizing treatment strategies for this patient subset is crucial for improving outcomes and quality of life.
Purpose of the Study:
- To evaluate the utility of microarray gene expression profiling (MAGE) in guiding personalized treatment decisions for MBC patients.
- To assess the clinical benefit and survival outcomes associated with MAGE-guided therapy in a cohort of heavily pretreated patients.
Main Methods:
- MBC patients with hormone therapy progression and a survival expectancy of at least 3 months were included.
- Microarray gene expression profiling (MAGE) was performed, analyzing genes known to interact with available drugs.
- Conventional sequencing, immunohistochemistry (IHC), and fluorescent in situ hybridization (FISH) complemented MAGE.
Main Results:
- A clinical benefit rate (stable disease + partial response) of 76% was observed in 30 evaluable patients who had received a median of 4 prior treatment lines.
- Median progression-free survival (PFS) was 6 months in patients achieving clinical benefit.
- Median overall survival (OS) for the entire series was 11 months.
Conclusions:
- MAGE provides valuable information for establishing personalized treatment plans in frail MBC patients with limited life expectancy.
- This approach can help mitigate therapeutic futility and guide treatment selection in challenging clinical scenarios.
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