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Utility of prognostic genomic tests in breast cancer practice: The impakt 2012 working group consensus statement

par Abdel Azim, Hatem Hamdy ;Michiels, Stefan ;Loi, Sherene ;Zagouri, Flora;Delaloge, Suzette;Andre, Fabrice;Filipits, Martin;Namer, Moïse;Neven, Patrick;Symmans, William Fraser;Thompson, Alastair;Swanton, Charles
Référence Annals of oncology, 24, 3, page (647-654), mds645
Publication Publié, 2013-03

Article révisé par les pairs

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Résumé :

Background: We critically evaluated the available evidence on genomic tests in breast cancer to define their prognostic ability and likelihood to determine treatment benefit. Design: Independent evaluation of six genomic tests [Oncotype DxTM, MammaPrint®, Genomic Grade Index, PAM50 (ROR-S), Breast Cancer Index, and EndoPredict] was carried out by a panel of experts in three parameters: analytical validity, clinical validity, and clinical utility based on the principles of the EGAPP criteria. Panel statements: The majority of the working group members found the available evidence on the analytical and clinical validity of Oncotype DxTM and MammaPrint® to be convincing. None of the genomic tests demonstrated robust evidence of clinical utility: it was not clear from the current evidence that modifying treatment decisions based on the results of a given genomic test could result in improving clinical outcome. Conclusions: The IMPAKT 2012 Working Group proposed the following recommendations: (i) a need to develop models that integrate clinicopathologic factors along with genomic tests; (ii) demonstration of clinical utility should be madein the context of a prospective randomized trial; and (iii) the creation of registries for patients who are subjected to genomic testing in the daily practice. © The Author 2013.