Breast cancer comes with many variables. A pair of powerful genomic tests can help women and their care teams make personalized care decisions.
For the more than 300,000 women diagnosed with breast cancer each year, one of the biggest challenges is uncertainty around treatment options. Treatment isn’t one-size-fits-all and often comes with steep costs in terms of side effects and deteriorating quality of life. Knowing what will work best for a specific patient requires accurate, personalized information about whether a cancer is likely to return after surgery and what treatments may be effective.
Breast cancer genomic testing, which examines gene activity inside a tumor, can provide that information by going beyond traditional clinical features to reveal underlying tumor biology. For instance, a precision oncology company, Agendia, offers two genomic tests for early breast cancer: MammaPrint® examines 70 genes to assess whether a cancer is likely to come back after surgery, and BluePrint® analyzes 80 genes to determine what biological pathways are driving the cancer to grow.
Illuminating pathways to better breast cancer care
Initially, genomic testing was developed to help clinicians determine whether patients who have hormone-driven breast cancer would benefit from chemotherapy. Now, through an accumulation of clinical evidence, we know that a tumor’s intrinsic biology can answer many questions over the course of diagnosis, treatment, and follow-up.
“It [early genomic tests] really only answered one question,” said Jaime Alberty, M.D., FACS, director of breast surgery, Comprehensive Breast Center, Kings County Hospital in New York. “Is a patient going to respond to chemotherapy or not? Now we can have a more nuanced discussion of how the tumor’s intrinsic biology helps guide patient care.”
For instance, information on what is driving a tumor’s growth can help clinicians identify which treatments will be most effective. This is crucial to ensuring that patients have the best possible chance of recovery.
As an example, many breast cancers grow in response to hormones and can be treated with hormone therapy. Others do not — requiring different interventions to prevent recurrence after surgery. Genomic testing, like BluePrint, can help clinicians identify patients whose cancer type is not hormone-driven, and ensure they receive the treatment best suited to their type of breast cancer.
Meanwhile, information on whether a cancer is likely to return after surgery can help clinicians better tailor the intensity of a treatment approach to the patient’s needs. For many women, hormone therapy effectively lowers the risk that breast cancer will come back, but it comes with challenging side effects. By identifying patients’ MammaPrint Risk Group, genomic testing can aid clinicians in determining who can safely avoid a full five years of hormone therapy, which is the current standard for care.
“When a patient is having a tough time with endocrine therapy, the test allows us to tell them, ‘Your tumor’s data tells us it’s OK to stop,’” Dr. Alberty explained.
To be an optimally useful tool, genomic testing must be comprehensive across breast cancer types and patient populations. When it is, the tests are game-changing. “We are trying to understand how a tumor behaves intrinsically,” Dr. Alberty said, “to treat people individually.”
See article via Future of Personal Health
