Clinical Practice Guidelines in Breast Cancer

Tyagi, Nidhi Kumar; Dhesy‐Thind, Sukhbinder

doi:10.3747/co.25.3729

Cited by 60 publications

(48 citation statements)

References 48 publications

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“…Here, we evaluated the impacts of RS based on 21-gene assay and St. Gallen International Expert Consensus on the treatment decision for patients with the early-stage invasive breast cancer. We also compared the benefits of 21-gene RS 14 The application of these guidelines has been shown to provide treatment benefits in terms of recurrence-free and overall survival. 15,16 However, different guidelines have some advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

“…NCCN guidelines and St. Gallen International Expert Consensus may be beneficial for treatment-related decision in patients with early-stage breast cancer. 14 We compared the agreement rate of NCCN guidelines and St. Gallen International Expert Consensus in treatment-related decision for 134 patients with breast cancer based on old and new RS cutoff criteria. It was found that the agreement rate is 50%, which overlapped in low and high RS cutoff patients.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to NCCN guidelines, some institutes use St. Gallen International Expert Consensus 13,14 to decide the therapeutic strategy for patients with breast cancer. The comparative advantages and disadvantage of NCCN guidelines and St. Gallen International Expert Consensus for the treatment of patients with breast cancer patients remain unknown.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of 21-gene assay and St.Gallen International Expert Consensus in the treatment decision for patients with early invasive breast cancers

Luo

et al. 2019

Cancer Biology & Therapy

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This study aimed to evaluate the impacts of 21-gene recurrence score (RS) and St. Gallen International Expert Consensus on treatment decision and prognosis of patients with invasive breast cancer. We retrospectively analyzed the therapy protocol and outcome of 134 cases based on age, body mass index (BMI), menopause, pathological types, tumor-node-metastasis (TNM) stages, percentage of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), Ki-67, molecular subtype, and tumor biomarkers. RS was calculated based on 21-gene assay following traditional (old RS cutoff) and updated (new RS cutoff) National Comprehensive Cancer Network (NCCN) guideline. In addition, we also compared treatment protocol of NCCN guidelines with St. Gallen International Expert Consensus. The results showed that BMI, PR, Ki-67, and molecular subtype are critical for the evaluation of risk factors. Based on the new cutoff, low, middle, and high RS were 18%, 66%, and 16%, respectively. In contrast, based on the old cutoff, low, middle, and high RS were 60%, 29%, and 11%, respectively. The agreement rate of NCCN guidelines and St. Gallen International Expert Consensus for adjuvant treatment was 50. However, there is minimal agreement (0.151, 0.071) in kappa coefficient of old and new cutoff. This study revealed that the combination of NCCN guidelines and St. Gallen International Expert Consensus might improve the benefits of adjuvant treatment in patients with early invasive breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of 21-gene assay and St.Gallen International Expert Consensus in the treatment decision for patients with early invasive breast cancers

Luo

et al. 2019

Cancer Biology & Therapy

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“…While death rates for many cancers have decreased significantly, there are still an estimated 600 000 cancer-related deaths each year in the USA 1. Breast, colon and lung cancers are among the three most common malignancies diagnosed in the USA and have well-defined treatment pathways with known benefits to chemotherapy in select subsets of patients 2–4. The National Quality Forum (NQF) has endorsed several metrics related to the appropriate administration of chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?

et al. 2019

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BackgroundChemotherapy quality measures consider hospitals compliant when chemotherapy is recommended, even if it is not received. This may mask shortcomings in cancer care delivery. Objectives of this study were to (1) identify patient factors associated with failure to receive recommended chemotherapy without a documented contraindication and (2) assess hospital variation in failure to administer recommended chemotherapy.MethodsPatients from 2005 to 2015 with breast, colon and lung cancers who failed to receive recommended chemotherapy were identified using the National Cancer Database. Hospital-level rates of failure to administer recommended chemotherapy were calculated, and patient and hospital factors associated with failure to receive recommended chemotherapy were identified by multivariable logistic regression.ResultsA total of 183 148 patients at 1281 hospitals were analysed. Overall, 3.5% of patients with breast, 6.6% with colon and 10.7% with lung cancers failed to receive recommended chemotherapy. Patients were less likely to receive recommended chemotherapy in all cancers if uninsured or on Medicaid (p<0.05), as were non-Hispanic black patients with both breast and colon cancer (p<0.001). Significant hospital variation was observed, with hospital-level rates of failure to administer recommended chemotherapy as high as 21.8% in breast, 40.2% in colon and 40.0% in lung cancers.Conclusions and relevanceThough overall rates are low, failure to receive recommended chemotherapy is associated with sociodemographic factors. Hospital variation in failure to administer recommended chemotherapy is masked by current quality measure definitions and may define a significant and unmeasured difference in hospital quality.

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“…Epithelial cancer accounts for about 95% of the OC [2]. Owing to the fact that nearly 70% of OC patients are diagnosed at stages III and IV according to the International Federation of Gynecology and Obstetrics (FIGO) and that more than 30% of OC patients will develop acquired chemoresistance and eventually relapse, the 5-year overall survival remains poor [3,4]. Thus, developing novel prognostic tools to stratify seemingly identical patients and redirect them to more precise therapies is of great importance.…”

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confidence: 99%

Development of a five-gene signature as a novel prognostic marker in ovarian cancer

Wang

Liu

et al. 2019

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The prognosis of ovarian cancer (OC) remains poor. Thus, the present study aims to identify independent prognostic factor in OC patients. OC gene expression studies GSE26712 and TCGA-OV were included in this study. Prognosis-associated differentially expressed genes (DEGs) between normal ovarian tissue and OC were identified. LASSO Cox proportional hazards regression model was conducted and a prognostic signature was constructed based on these DEGs. The predictive ability of the signature was analyzed in the training set and test set. The prognosis performance of the signature was compared with CA-125 and HE4. Gene set enrichment analysis (GSEA) was conducted to identify relevant mechanism. 332 DEGs were identified, out of which 64 DEGs were significantly correlated with the overall survival (OS) of OC patients, and 5 DEGs (IGF2, PEG3, DCN, LYPD1 and RARRES1) were applied to build a 5-gene signature. Patients in the 5-gene signature low-risk group had significantly better OS compared to those in the 5-gene high-risk group (p=0.0004) in the training set. Similar results were found in the test set, and the signature was also an independent prognostic factor. The prognosis performance of the 5-gene signature was significantly better than that of CA-125 and HE4. GSEA suggested that OC samples in the 5-gene high-risk group were significantly enriched in WNT/β-catenin signaling and epithelialmesenchymal transition. We developed and validated a 5-gene signature that might be used as an independent prognostic factor in patients with OS.

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Clinical Practice Guidelines in Breast Cancer

Cited by 60 publications

References 48 publications

Comparison of 21-gene assay and St.Gallen International Expert Consensus in the treatment decision for patients with early invasive breast cancers

Comparison of 21-gene assay and St.Gallen International Expert Consensus in the treatment decision for patients with early invasive breast cancers

Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?

Development of a five-gene signature as a novel prognostic marker in ovarian cancer

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