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Gene expression profiling to guide selection of adjuvant therapy in breast cancer

Breast cancer is in Sweden the most common form of cancer in women and one of the most frequent causes of death in middle-aged women. Molecular genetic tests studying the expression of genes associated with example given metastasizing (spreading of the cancer to other body parts) could help in refining the risk assessment of tumours before decision of adjuvant therapy after surgery. Histopathologic examination is in Sweden routine to guide selection of adjuvant therapy and gene expression profiling is only performed on a research basis.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Question

What is the current state of scientific knowledge regarding gene expression profiling to guide selection of adjuvant therapy in breast cancer?

Identified literature

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  21. Marchionni L, Wilson RF, Wolff AC, Marinopoulos S, Parmigiani G, Bass EB, et al. Systematic review: gene expression profiling assays in early-stage breast cancer. Ann Intern Med 2008;148:358-69.
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  24. Cadth. Oncotype DX in women and men with ER-positive HER2-negative early stage breast cancer Who are lymph node-positive: a review of clinical effectiveness and guidelines (Structured abstract). Health Technology Assessment Database 2014.
  25. Ward S, Scope A, Rafia R, Pandor A, Harnan S, Evans P, et al. Gene expression profiling and expanded immunohistochemistry tests to guide the use of adjuvant chemotherapy in breast cancer management: a systematic review and cost-effectiveness analysis. Health Technol Assess 2013;17:1-302.
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Literature search

Literature search gene expression.pdf

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