Among women with newly diagnosed breast cancer, a predictive test successfully identified those with a high probability of survival following taxane and anthracycline chemotherapy.
As Christos Hatzis, PhD, of Nuvera Biosciences Inc. (Woburn, Massachusetts), and collaborators noted, “Identification of those with significant risk of relapse despite standard chemotherapy could be used to advise participation in an appropriate clinical trial of potentially more effective treatment” (JAMA. 2011;305:1873-1881).
Hatzis’s group conducted a 10-year study at the M. D. Anderson Cancer Center to develop and test genomic predictors for neoadjuvant chemotherapy for women with newly diagnosed ERBB2 (HER2 or HER2/neu)-negative breast cancer treated with chemotherapy containing sequential taxane and antrhacycline-based regimens, followed by endocrine therapy if estrogen-receptor [ER]-positive).
The investigators developed different predictive signatures for resistance and response to preoperative chemotherapy using gene expression microarrays from 310 such patients. The test combined ER status, predicted chemoresistance, predicted chemosensitivity, and predicted endocrine sensitivity.
The chemopredictive test algorithm had a positive predictive value of 56% for prediction of pathologic response, after excluding women with predicted endocrine sensitivity. Among 28% of participants predicted to be treatment-sensitive, the 3-year distant relapse-free survival (DRFS) rate was 92%.
“Overall, there was a significant association between predicted sensitivity to treatment and improved DRFS,” wrote Hatzis and colleagues.