70 Genetic Testing With New Clinical Trial Results!
The first 70 genetic tests were shown to have a predictive effect on outcomes in patients with early-stage breast cancer. In addition, nearly 23% of patients with low-risk early-stage breast cancer are exempt from chemotherapy without affecting treatment effectiveness and survival.
These results were derived from a large prospective clinical trial, MINDACT, which included 6693 women with breast cancer, to study better breast cancer treatment based on the results of 70 genetic tests.
In 2022, the results of this clinical trial are still being updated, and the treatment guidelines for breast cancer patients are more recommended.
1
Patients with ultra-low-risk traits of the 70 gene have the best prognosis,
Minimal transfer
Of all the patients with early-stage breast cancer who participated in this Phase III clinical trial[1], 70 genetic tests found that 15% (1000) of patients had an ultra-low risk (49% low risk and 36% high risk).
Patients in the ultra-low-risk group have the following characteristics:
67% were >50 years of age, 80% were node-negative, 81% had tumors less than 2 cm, 96% were grade 1 or 2, and 99% were ER positive (97% were HR+ and HER2-).
Treatment received by patients in the ultra-low-risk group:
84% received systemic therapy (of which 69% received endocrine therapy, 14% received endocrine therapy + chemotherapy, 1% received other treatments);
16% did not receive systemic adjuvant therapy.
What is the prognosis for patients in the ultra-low-risk group?
The median follow-up time was more than 8 years, with 97% of patients in the ultra-low-risk group without distant metastasis within 8 years and 94.5% in the low-risk group.
From the perspective of 8-year specific survival of breast cancer, the proportion of patients in the ultra-low risk group is as high as 99.6%.
2
Adjuvant endocrine therapy is beneficial for patients with low-risk breast cancer
Reduces long-term transfers
Another report based on this clinical trial [2] focuses on which treatments are best for patients with low-risk breast cancer.
Given that various treatments have certain side effects and adverse reactions, how to measure the pros and cons of receiving treatment for low-risk breast cancer patients is a problem that must be faced.
The study grouped a group of breast cancer patients with estrogen receptor positivity, HER2-negative, lymph node-negative, tumor ≤ 2 cm by matching, with one group receiving no systemic adjuvant therapy and the other receiving only adjuvant endocrine therapy.
Outcomes (angles of whether adjuvant endocrine therapy has an advantage):
There is no proportion of distant transfer within 8 years, which has certain advantages:
94.8% of the group without systemic treatment and 97.3% of the endocrine treatment group only;
There is no advantage in the 8-year overall survival (OS) rate:
95.4% of the group without systemic treatment and 95.6% of the endocrine therapy group only;
The cumulative incidence of localized recurrence and contralateral breast cancer has advantages:
The group without systemic treatment was 4.7% and 4.6%, respectively, and the endocrine treatment-only group was 1.4% and 1.5%, respectively.
The above results show that for low-risk early-stage breast cancer patients with estrogen receptor-positive, HER2-negative, lymph node-negative, tumor ≤2 cm, no systemic therapy does not affect overall survival. However, adjuvant endocrine therapy significantly reduces some breast cancer-related events.
Patients who have experienced breast cancer treatment, whether it is surgery, chemoradiotherapy or endocrine therapy, have deeply experienced the impact of treatment side effects on quality of life, as well as the long and difficult process of managing adverse reactions.
The update of the latest clinical data has given patients with early breast cancer an effective treatment and greatly reduced the side effects of overtreatment when choosing a treatment plan.
How to do 70 genetic testing in China? What do you think of the result?
At present, the domestic 70 genetic testing is only completed by the exclusive agent genetic testing company. Breast cancer patients who are interested in testing can consult their doctor in advance whether they are suitable for this test before deciding whether to do 70 genetic testing.
Patients can contact the genetic testing company themselves for testing and other operations;
Patients can also choose a medical institution with relevant genetic testing cooperation for scheduled testing.
The advantage of choosing the second method is that the doctors in the medical institution can help determine whether the 70 gene test is suitable, and there will also be a commissioner to guide the specimen sampling and sending related matters, and the follow-up report interpretation and follow-up treatment guidance are also involved in the completion of the clinician.
bibliography
[1] Lopes Cardozo JMN, et al. Outcome of Patients With an Ultralow-Risk 70-Gene Signature in the MINDACT Trial. J Clin Oncol. 2022 Jan 21:JCO2102019.
[2] Lopes Cardozo JMN, et al. Outcome without any adjuvant systemic treatment in stage I ER+/HER2- breast cancer patients included in the MINDACT trial. Ann Oncol. 2022 Mar;33(3):310-320.