Clinical utility of gene-expression profiling in women with early breast cancer: an overview of systematic reviews

Details

• Alternative Title:
  Genet Med
• Personal Author:
  Marrone, Michael ; Stewart, Alison ; Dotson, W. David
• Description:
  Purpose
  
  This overview systematically evaluates the clinical utility of using Oncotype DX and MammaPrint gene-expression profiling tests to direct treatment decisions in women with breast cancer. The findings are intended to inform an updated recommendation from the Evaluation of Genomic Applications in Practice and Prevention Working Group.
  
  Methods
  
  Evidence reported in systematic reviews evaluating the clinical utility of Oncotype DX and MammaPrint, as well as the ability to predict treatment outcomes, change in treatment decisions, and cost-effectiveness, was qualitatively synthesized.
  
  Results
  
  Five systematic reviews found no direct evidence of clinical utility for either test. Indirect evidence showed Oncotype DX was able to predict treatment effects of adjuvant chemotherapy, whereas no evidence of predictive value was found for MammaPrint. Both tests influenced a change in treatment recommendations in 21 to 74% of participants. The cost-effectiveness of Oncotype DX varied with the alternative compared. For MammaPrint, lack of evidence of the predictive value led to uncertainty in the cost-effectiveness.
  
  Conclusion
  
  No studies were identified that provided direct evidence that using gene-expression profiling tests to direct treatment decisions improved outcomes in women with breast cancer. Three ongoing studies may provide direct evidence for determining the clinical utility of gene-expression profiling testing.
  
  
• Subjects:
  Article Breast Cancer Breast Neoplasms Clinical Utility Cost-Benefit Analysis Evidence-based Medicine Female Gene-expression Profiling Gene Expression Profiling Humans Predictive Value Of Tests Prognosis Transcriptome Treatment Outcome

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• Source:
  Genet Med. 17(7):519-532.
• Pubmed ID:
  25474343
• Pubmed Central ID:
  PMC4698966
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  17
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5a5349b3ee2e8eca3bbfc3467277ce91f24889ad53b69c6a4e39a2697e982c71
• Download URL:
  https://stacks.cdc.gov/view/cdc/37224/cdc_37224_DS1.pdf
• File Type:
  [PDF - 580.55 KB ]