Incorporating clinicopathological and molecular risk prediction tools to improve outcomes in early HR+/HER2- breast cancer.
Curigliano GiuseppeRebecca DentAntonio Llombart-CussacMark D PegramLajos PusztaiNicholas C TurnerGiuseppe VialePublished in: NPJ breast cancer (2023)
Stratification of recurrence risk is a cornerstone of early breast cancer diagnosis that informs a patient's optimal treatment pathway. Several tools exist that combine clinicopathological and molecular information, including multigene assays, which can estimate risk of recurrence and quantify the potential benefit of different adjuvant treatment modalities. While the tools endorsed by treatment guidelines are supported by level I and II evidence and provide similar prognostic accuracy at the population level, they can yield discordant risk prediction at the individual patient level. This review examines the evidence for these tools in clinical practice and offers a perspective of potential future risk stratification strategies. Experience from clinical trials with cyclin D kinase 4/6 (CDK4/6) inhibitors in the setting of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) early breast cancer is provided as an illustrative example of risk stratification.
Keyphrases
- epidermal growth factor receptor
- early breast cancer
- clinical trial
- clinical practice
- tyrosine kinase
- early stage
- type diabetes
- endothelial cells
- case report
- randomized controlled trial
- high throughput
- insulin resistance
- metabolic syndrome
- advanced non small cell lung cancer
- social media
- combination therapy
- risk assessment
- human health
- weight loss