Breast cancer multigene test allows targeted use of chemotherapy

Multigentest helps to use chemotherapy in breast cancer more targeted

In breast cancer therapy, multiple tests may be used to determine the risk of metastasis. According to German scientists, this test helps to use chemotherapy more specifically and thus to improve the chances of recovery.

Most common cancer in women

Breast cancer is the most common malignant tumor in women. In Germany alone, up to 70,000 new cases are counted each year. Many patients have to undergo chemotherapy with adverse side effects. However, experts have long pointed out that breast cancer does not always make sense. New genetic tests were reported last year to eliminate unnecessary chemotherapy for breast cancer. However, some genetic tests can also enable the targeted use of chemotherapy in breast cancer, as scientists from Munich found.

According to German researchers, a multi-test can help to use chemotherapy in breast cancer more targeted and thus improve the chances of recovery. (Image: RFBSIP / fotolia.com)

Multi-tests in breast cancer therapy

For several years now, the Isar hospital for women with a specific breast cancer variant - hormone receptor-positive, HER2-negative breast cancer - has been using a so-called multi-test in the Department of Gynecology of the Klinikum rechts.

According to a report from the Technical University of Munich (TUM), it can be used to make a statement about the patient's risk of developing metastases in the future based on tissue samples and other clinical features.

A team from the Breast Center at Klinikum rechts der Isar of the TUM has now presented results from the clinical routine.

According to them, the multi-test used at the hospital actually helps to use chemotherapy more specifically and thus to improve the chances of recovery.

Chemotherapy can be an unnecessary heavy burden

"On the basis of the test result, which includes not only molecular-biological tumor properties but also the individual factors of tumor size and lymph node involvement, doctors decide whether, in addition to surgical removal of the tumor and subsequent anti-hormonal treatment, chemotherapy makes sense", explains Prof. Marion Kiechle. Director of the gynecological clinic.

"With a low risk of metastasis, chemotherapy can be an unnecessarily heavy burden, and at high risk, therapy can prevent new tumors from developing later."

Dr. Johannes Ettl, Senior Physician at the Women's Hospital's Interdisciplinary Breast Center, presented the results of the independent non-test care study for the breast center test at the San Antonio Breast Cancer Symposium in the United States, one of the world's premier congresses for breast cancer , in front.

The subject of the investigation was the EndoPredict test, one of the four most common breast cancer tests used in Germany.

When it was first introduced in 2011, it was the first test to consider both gene signatures and classical clinical parameters such as tumor size and lymph node involvement.

Tests help with the targeted use of chemotherapy

For the study, the researchers analyzed how the breast cancer disease actually progressed in 373 patients in the years following the start of the first treatment and associated test.

The test had low risk for 238 patients (63.8 percent) and high risk for 135 (36.2 percent).

It was found that after a median follow-up of 3.5 years in patients in the "high-risk group" compared to the "low-risk group" in practice, the likelihood was twice as high that the breast cancer reappeared and even five times it was high that metastases formed in other organs.

Among the low-risk and high-risk patients treated with chemotherapy in addition to the anti-hormone tablet, 96.6 percent (low-risk group) and 96.3 percent (high-risk and chemotherapy) without breast cancer lived at three years of age.

In the case of high-risk patients, for whom no chemotherapy was used despite the doctors' test-based recommendation, this figure was only 91.5 percent.

"Our observational study provides data from routine clinical care for the first time, showing that the test can indeed provide important clues to the decision for or against chemotherapy," said Prof. Marion Kiechle.

"Gene signature testing is an important tool that helps us to target chemotherapy more effectively, avoiding both unnecessary use of these high-impact therapies and a potentially momentous renunciation of chemotherapy at high metastasis risk." (Ad)