Open this publication in new window or tab >>St. Vincent’s University Hospital, Dublin, Ireland.
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Institute, Amsterdam, Netherlands.
Cardiff and Vale UHB - General Surgery, Cardiff, United Kingdom.
Havyatt Lodge, Havyatt Road, North Somerset, Langford, United Kingdom.
Iberoamerican Cochrane Center, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain.
Iberoamerican Cochrane Center, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain.
Department for Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands; Dutch Expert Centre for Screening, Nijmegen, Netherlands.
Radiologie am Theater, NRW, Paderborn, Germany.
Iberoamerican Cochrane Center, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain; Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.
Centre for Cancer Prevention, Queen Mary University of London, Charterhouse Square, London, United Kingdom.
Michael G. DeGroote Cochrane Canada and McGRADE Centres; Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, ON, Hamilton, Canada.
Cancer Registry of Milan, Milan, Italy.
Institute of Global Health. University of Geneva, Geneva, Switzerland.
IMIM, Barcelona, Spain.
European Centre for Disease Control and prevention (ECDC), Solna, Sweden.
Charles University in Prague, Prague, Czech Republic.
National Screening Service, Dublin, Ireland.
CPO-Piedmont - AOU Citta` della Salute e della Scienza, Torino, Italy.
Cancer Registry of Norway, Oslo, Norway.
University of Athens Medical School, Athens, Greece.
Europa Donna, Milan, Italy.
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
European Commission, Joint Research Centre, Ispra, Italy.
University Hospital Dr. Josep Trueta, Girona, Spain.
Ospedale Niguarda Ca’ Granda, Milan, Italy.
Dutch Reference Centre for Screening, Nijmegen, Netherlands.
Dutch Reference Centre for Screening, Nijmegen, Netherlands.
National Coordinating Centre for the Physics of Mammography, Guildford, United Kingdom.
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2021 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 124, no 9, p. 1503-1512Article, review/survey (Refereed) Published
Abstract [en]
Background: Predicting the risk of recurrence and response to chemotherapy in women with early breast cancer is crucial to optimise adjuvant treatment. Despite the common practice of using multigene tests to predict recurrence, existing recommendations are inconsistent. Our aim was to formulate healthcare recommendations for the question “Should multigene tests be used in women who have early invasive breast cancer, hormone receptor-positive, HER2-negative, to guide the use of adjuvant chemotherapy?”
Methods: The European Commission Initiative on Breast Cancer (ECIBC) Guidelines Development Group (GDG), a multidisciplinary guideline panel including experts and three patients, developed recommendations informed by systematic reviews of the evidence. Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision frameworks were used. Four multigene tests were evaluated: the 21-gene recurrence score (21-RS), the 70-gene signature (70-GS), the PAM50 risk of recurrence score (PAM50-RORS), and the 12-gene molecular score (12-MS).
Results: Five studies (2 marker-based design RCTs, two treatment interaction design RCTs and 1 pooled individual data analysis from observational studies) were included; no eligible studies on PAM50-RORS or 12-MS were identified and the GDG did not formulate recommendations for these tests.
Conclusions: The ECIBC GDG suggests the use of the 21-RS for lymph node-negative women (conditional recommendation, very low certainty of evidence), recognising that benefits are probably larger in women at high risk of recurrence based on clinical characteristics. The ECIBC GDG suggests the use of the 70-GS for women at high clinical risk (conditional recommendation, low certainty of evidence), and recommends not using 70-GS in women at low clinical risk (strong recommendation, low certainty of evidence).
Place, publisher, year, edition, pages
Springer, 2021
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-186339 (URN)10.1038/s41416-020-01247-z (DOI)2-s2.0-85101181473 (Scopus ID)
2021-07-222021-07-222021-07-22Bibliographically approved