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基因表达特征测试以指导淋巴结阳性早期乳腺癌的辅助化疗决策:系统性审查

Katy Cooper¹, Gamze Nalbant², Munira Essat²

¹School of Medicine and Population Health, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. k.l.cooper@sheffield.ac.uk.

Breast cancer research and treatment

|February 3, 2025

概括

基因表达分析测试,如瘤型DX,显示了淋巴结阳性乳腺癌复发的预后能力. 型DX的使用减少了化疗建议,但预测益处的证据有限.

科学领域:

在瘤学瘤学.
基因组学就是基因组学.
临床决策 - 临床决策

背景情况:

激素受体阳性 (HR+) 早期的淋巴结参与 (LN+) 的乳腺癌通常需要决定辅助化疗.
基因表达分析 (GEP) 试验旨在通过评估个体瘤生物学来完善这些决定.

研究的目的:

在指导HR+,LN+早期乳腺癌的辅助化疗决策时,系统地审查GEP测试 (Oncotype DX,Prosigna,EndoPredict,MammaPrint) 的有效性.

主要方法:

系统审查2023年4月之前发表的研究,搜索MEDLINE,EMBASE和Cochrane数据库.
评估预后能力,预测化疗效益,对治疗决策的影响,生活质量和焦虑.

主要成果:

所有四个GEP测试都显示了在LN+患者中远程复发的预后能力.
RxPONDER试验表明,在经期前的LN+患者中,经期前的LN+患者具有高的瘤型DX得分,但在经期后的患者中,经期后的DX得分较低,化学疗法有益.
型DX测试导致英国和欧洲的化疗建议减少12-75%.
对于GEP测试的预测效益的证据有限,特别是对于Prosigna,EndoPredict和MammaPrint,关于化疗效益或治疗决策的证据有限.

结论:

所有审查的GEP测试对LN+乳腺癌患者具有预后能力.
支持GEP测试对化疗益处的预测价值的证据不那么强大,瘤型DX在绝经后患者中显示了模两可的结果.
型DX测试的实施显然减少了推辅助化疗的患者数量.

关键词:

辅助性化疗是一种辅助性化疗.乳腺新生体的形成.基因表达特征分析预测性测试是指预测性测试.系统性审查系统性审查

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