Gene expression assays gather evidence that they can provide useful therapeutic information in young women
Moataz Dowaidar
Abstract
Gene expression assays have been shown to be therapeutically beneficial in young women with lobular disease and long-term consequences.Prospective randomized studies consistently suggest that chemotherapy may be avoided in women over 50 years old with an intermediate risk recurrence score (pN0) or a low genetic risk (MammaPrint) (pN0–1); nevertheless, a slight benefit from adjuvant chemotherapy can not be ruled out in women 50 years or less. In order to quantify the incremental advantage of a specific therapy technique, the ESMO Magnitude of Clinical Benefit Scale was recently used for EBC therapies. For optimum individual benefit in early luminal EBC, risk-adapted treatment concepts are still crucial. More de-escalation trials are required in order to optimize adjuvant therapy in EBC. An endocrine-based approach with abemaciclib, in addition to adjuvant chemotherapy, has recently emerged as an alternate option for treatment intensification in high-risk luminal EBC.