NanoString: Intrinsic Subtypes and 21-Gene Assay Predict Recurrence in Early Stage HER2+ Breast Cancer from Saranya Chumsri MD
By Saranya Chumsri, MD
Breast cancer is a complex disease with many different subtypes that can impact treatment decisions and patient outcomes. HER2-positive breast cancer is a subtype that is characterized by the overexpression of the HER2 protein, and accounts for approximately 20% of all breast cancer cases.
The North Central Cancer Treatment Group (NCCTG) N9831 (Alliance) Trial was a large, randomized clinical trial that evaluated the use of chemotherapy and trastuzumab (Herceptin) in the treatment of HER2-positive breast cancer. The trial enrolled over 3,000 patients with early stage HER2-positive breast cancer, and has provided important insights into the management of this subtype of breast cancer.
A recent analysis of the NCCTG N9831 (Alliance) Trial, presented at the 2022 San Antonio Breast Cancer Symposium, evaluated the effects of intrinsic subtypes and the 21-gene assay on early and late recurrence risks in patients with early stage HER2-positive breast cancer.
The analysis found that patients with HER2-positive, luminal B-like intrinsic subtypes had a higher risk of both early and late recurrence compared to patients with HER2-positive, luminal A-like intrinsic subtypes. Additionally, the 21-gene assay was found to be a strong predictor of early recurrence risk, but was not found to be a predictor of late recurrence risk.
These findings have important implications for the management of HER2-positive breast cancer. They suggest that intrinsic subtyping and the 21-gene assay may be useful tools in identifying patients at higher risk of recurrence, and may help guide treatment decisions, such as the use of adjuvant chemotherapy or extended adjuvant therapy with trastuzumab.
The analysis also highlights the importance of continued research in understanding the complex nature of breast cancer subtypes and their impact on patient outcomes. By identifying subtypes and biomarkers that are associated with higher recurrence risks, clinicians can develop more personalized treatment plans that are tailored to each patient’s unique needs and circumstances.
Overall, the NCCTG N9831 (Alliance) Trial analysis represents an important contribution to the field of breast cancer research, and provides valuable insights into the management of HER2-positive breast cancer. By continuing to study the complex nature of breast cancer subtypes and biomarkers, clinicians can improve outcomes for patients with this challenging disease.
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10 Key Takeaways from NCCTG N9831 Clinical Trial
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The North Central Cancer Treatment Group (NCCTG) N9831 (Alliance) Trial was a large, randomized clinical trial that evaluated the use of chemotherapy and trastuzumab in the treatment of HER2-positive breast cancer.
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The trial enrolled over 3,000 patients with early stage HER2-positive breast cancer and has provided important insights into the management of this subtype of breast cancer.
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Intrinsic sub-typing and the 21-gene assay were evaluated as predictors of early and late recurrence risks in patients with early stage HER2-positive breast cancer.
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Patients with HER2-positive, luminal B-like intrinsic subtypes had a higher risk of both early and late recurrence compared to patients with HER2-positive, luminal A-like intrinsic subtypes.
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The 21-gene assay was found to be a strong predictor of early recurrence risk in patients with early stage HER2-positive breast cancer.
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The 21-gene assay was not found to be a predictor of late recurrence risk in patients with early stage HER2-positive breast cancer.
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Intrinsic sub-typing and the 21-gene assay may be useful tools in identifying patients at higher risk of recurrence in early stage HER2-positive breast cancer.
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Identifying subtypes and biomarkers associated with higher recurrence risks may help guide treatment decisions, such as the use of adjuvant chemotherapy or extended adjuvant therapy with trastuzumab.
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Continued research is needed to better understand the complex nature of breast cancer subtypes and biomarkers and their impact on patient outcomes.
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The findings of the NCCTG N9831 (Alliance) Trial analysis provide valuable insights into the management of HER2-positive breast cancer and may help improve outcomes for patients with this challenging disease.
What is NanoString Technologies in early stage HER2+ breast cancer?
NanoString is a cutting-edge technology that has shown great promise in the treatment of early stage HER2+ breast cancer. It is a type of genomic testing that uses a digital multiplex technology to measure the expression of multiple genes simultaneously, allowing for a more comprehensive analysis of the tumor.
In HER2+ breast cancer, the overexpression of the HER2 protein drives the growth of the tumor, making it an important therapeutic target. NanoString technology can help identify HER2+ tumors and determine the best treatment options based on the unique genetic makeup of the tumor.
What did a recent study find about the use of NanoString in early stage HER2+ breast cancer?
One recent study found that the use of NanoString technology can accurately identify HER2+ breast cancer in early stage patients with high accuracy, even in cases where traditional HER2 testing may not have detected it. This is particularly important because HER2+ breast cancer requires different treatment strategies than other types of breast cancer, such as chemotherapy and HER2-targeted therapies like trastuzumab.
Furthermore, NanoString can provide valuable information about the tumor’s genomic profile, allowing for more personalized treatment plans. For example, it can identify other genetic mutations that may affect the tumor’s response to therapy, such as the presence of TP53 mutations or PTEN loss.
In addition to its diagnostic applications, NanoString technology can also be used to monitor treatment response and disease progression over time. This can help doctors adjust treatment plans as needed to optimize patient outcomes.
In conclusion, NanoString is a powerful tool for the diagnosis and treatment of early stage HER2+ breast cancer. Its ability to provide comprehensive genomic information about the tumor can help doctors develop personalized treatment plans and monitor treatment response over time, ultimately leading to better outcomes for patients.
Saranya Chumsri, MD – About The Author, Credentials, and Affiliations
Saranya Chumsri, MD, is a highly skilled physician and accomplished researcher at the Mayo Clinic. She is a Professor of Medicine at the Mayo Clinic in Jacksonville, Florida. She works in the Division of Hematology and Oncology and the Department of Medicine.
Dr. Chumsri obtained her medical degree from Chulalongkorn University in Bangkok, Thailand, before completing her residency in internal medicine at the University of Texas Southwestern Medical Center. She then pursued a fellowship in hematology and oncology at the Mayo Clinic in Rochester, Minnesota, where she subsequently served on the faculty before moving to the Jacksonville campus in 2015.
With over two decades of clinical experience in hematology and oncology, Dr. Chumsri is an expert in the diagnosis and management of a wide range of cancers, including breast cancer, ovarian cancer, and lung cancer. She is particularly known for her expertise in the treatment of triple-negative breast cancer, an aggressive form of breast cancer that can be difficult to treat.
Dr. Chumsri works as a doctor, but she is also an active researcher. She is especially interested in finding new ways to treat breast cancer. Her research has been published in a number of high-impact journals, and the National Cancer Institute and other well-known organizations have given her money to help her with her work.
Dr. Chumsri is committed to providing compassionate, personalized care to each of her patients and is dedicated to advancing the field of hematology and oncology through her research and clinical practice. She has a lot of respect from both her colleagues and her patients because of her knowledge, professionalism, and drive to do her best.