A Pathology-Based Combined Model to Identify PAM50 Non-luminal Intrinsic Disease in Hormone Receptor-Positive HER2-Negative Breast Cancer
Conclusions: In the absence of gene expression data, NOLUS can help identify non-luminal disease within HR+/HER2-negative breast cancer.
Introduction
Gene expression profiling has had a considerable impact on our understanding of hormone receptor-positive (HR+)/HER2-negative breast cancer biology (1, 2). During the last decade, two intrinsic molecular subtypes within HR+/HER2-negative disease (i.e., Luminal A and Luminal B) have been identified and intensively studied (3–5). These studies have led to well-validated prognostic gene expression-based tests such as Prosigna (6), OncotypeDX (7), MammaPrint (8), Breast Cancer Index (9),and EndoPredict (10). The implementation of these 4 platforms in the clinical practice has been essential in order to identify a subset of Luminal A tumors that can safely spare (neo)adjuvant chemotherapy treatments because of their good prognostic (11–13).
At the same time, cumulative evidence from recent studies suggests that 5–30% of HR+/HER2-negative tumors are not Luminal A or B by gene expression and fall into the HER2-enriched (HER2-E) and Basal-like categories (14). From a clinical perspective, these non-luminal tumors have been associated with low estrogen dependency (15–17), high chemo-sensitivity (18–20), potential lower activity of CDK4/6 inhibitors (21, 22) and poor outcome in both early and the advanced/metastatic breast cancer (22–24). Thus, clinic...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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