First versus second-generation molecular profiling tests: How both can guide decision-making in early-stage...

Area of Science:

• Oncology
• Genomics
• Clinical Decision Support

Background:

• Hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) breast cancers are common but show varied responses to adjuvant treatment.
• Tumor heterogeneity complicates treatment decisions, potentially leading to overtreatment based on clinical and pathological factors alone.
• Accurate identification of patients benefiting from adjuvant chemotherapy is a significant clinical challenge.

Purpose of the Study:

• To compare the advantages and limitations of Oncotype DX and Prosigna molecular profiling tests.
• To discuss how these tests can improve clinical decision-making for early-stage HR+/HER2- breast cancers.
• To identify knowledge gaps and suggest future research directions.

Main Methods:

• Review of studies directly comparing Oncotype DX and Prosigna.
• Analysis of prognostic and predictive capabilities of the molecular tests.
• Focus on early-stage, hormone receptor-positive breast cancer applications.

Main Results:

• Both Oncotype DX and Prosigna are effective prognostic tools for early breast cancer.
• Oncotype DX has demonstrated utility as a predictive tool for guiding chemotherapy decisions.
• Comparative studies inform the optimal use of these molecular tests.

Conclusions:

• Multigene profiling assays are valuable for assessing recurrence risk and chemotherapy response in HR+ breast cancer.
• Leveraging the strengths of Oncotype DX and Prosigna can enhance personalized treatment strategies.
• Further research is needed to address remaining knowledge gaps in molecular testing for breast cancer.