What to Expect From the New ASCO/CAP Guideline Recommendations for Hormone Receptor Testing in Breast Cancer: A National Reference Laboratory Experience

Mahlow, Jonathon; Goold, Eric; Jedrzkiewicz, Jolanta; Gulbahce, H. Evin

doi:10.1097/pai.0000000000000891

Cited by 6 publications

(5 citation statements)

References 18 publications

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“… 25 In brief, tumors were evaluated for ER and PgR using immunohistochemistry as per the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) consensus. 26 HER2 status was identified by Herceptest (DAKO Agilent pathology solutions, Santa Clara, CA), with a score of 3+ considered positive. Any 2+ inconclusive results were confirmed using fluorescent in situ hybridization.…”

Section: Methodsmentioning

confidence: 99%

“…Breast cancer molecular subtypes were classified using the 12th St. Gallen Expert Consensus panel 25. In brief, tumors were evaluated for ER and PgR using immunohistochemistry as per the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) consensus 26. HER2 status was identified by Herceptest (DAKO Agilent pathology solutions, Santa Clara, CA), with a score of 3+ considered positive.…”

Section: Methodsmentioning

confidence: 99%

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Evaluating the Role of Circulating MicroRNAs to Aid Therapeutic Decision Making for Neoadjuvant Chemotherapy in Breast Cancer

et al. 2022

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Objective: To evaluate whether circulating micro ribonucleic acids (miRNAs) predict response to neoadjuvant chemotherapy (NAC) and inform decision-making in breast cancer patients. Introduction: Deciphering response to NAC remains a challenge. Those unlikely to respond may benefit from NAC de-escalation before completion, while “responders” should complete treatment. Establishing biomarkers which identify response to NAC is imperative to personalize treatment strategies. miRNAs are small noncoding RNA molecules which modulate genetic expression. miRNAs are believed to inform response to NAC. Methods: This prospective, multicenter trial (NCT01722851) recruited 120 patients treated with NAC across 8 Irish treatment sites. Predetermined miRNAs were quantified from patient whole bloods using relative quantification polymerase chain reactiond. Venous sampling was performed at diagnosis and midway during NAC. Trends in miRNA expression between timepoints were correlated with treatment response. Data analysis was performed using R 3.2.3. Results: A total of 120 patients were included (median age: 55 years). Overall, 49.2% had luminal breast cancers (59/120), 17.5% luminal B (L/HER2) (21/120), 12.5% human epidermal growth factor receptor-2 positive (HER2+) (15/120), and 20.8% triple negative disease (25/120). In total, 46.7% of patients responded to NAC (56/125) and 26.7% achieved a pathological complete response (pCR) (32/120). For patients with L/HER2, increased Let-7a predicted response to NAC (P=0.049), while decreased miR-145 predicted response to NAC in HER2+ (P=0.033). For patients with luminal breast cancers, reduced Let-7a predicted achieving a pCR (P=0.037) and reduced miR-145 predicted achieving a pCR to NAC in HER2+ (P=0.027). Conclusions: This study illustrates the potential value of circulatory miRNA measurement in predicting response to NAC. Further interrogation of these findings may see miRNAs personalize therapeutic decision-making for patients undergoing NAC for early breast cancer.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Evaluating the Role of Circulating MicroRNAs to Aid Therapeutic Decision Making for Neoadjuvant Chemotherapy in Breast Cancer

et al. 2022

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“…Tumour specimens underwent classification into breast cancer molecular subtypes using the 11th St. Gallen Expert Consensus panel [ 28 ], based on the work of Perou et al [ 29 ]. Specimens were analysed as per the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) histopathological consensus guidelines for oestrogen (ER) and progesterone (PgR) receptor status using immunohistochemistry [ 30 , 31 ]. Human epidermal growth factor receptor-2 (HER2) receptor status was delineated using Herceptest™ (DAKO Agilent pathology solutions, Santa Clara, CA, USA), where 3 + was considered to be HER2-positive, with 2 + inconclusive results confirmed using fluorescent in situ hybridisation testing [ 32 , 33 ].…”

Section: Methodsmentioning

confidence: 99%

Circulating microRNAs can predict chemotherapy-induced toxicities in patients being treated for primary breast cancer

Davey

Abbas²,

Kerin³

et al. 2023

Breast Cancer Res Treat

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Purpose Prescribing NAC for breast cancer is a pragmatic treatment strategy for several reasons; however, certain patients suffer chemotherapy-induced toxicities. Unfortunately, identifying patients at risk of toxicity often proves challenging. MiRNAs are small non-coding RNA molecules which modulate genetic expression. The aim of this study was to determine whether circulating miRNAs are sensitive biomarkers that can identify the patients likely to suffer treatment-related toxicities to neoadjuvant chemotherapy (NAC) for primary breast cancer. Methods This secondary exploratory from the prospective, multicentre translational research trial (CTRIAL ICORG10/11–NCT01722851) recruited 101 patients treated with NAC for breast cancer, from eight treatment sites across Ireland. A predetermined five miRNAs panel was quantified using RQ-PCR from patient bloods at diagnosis. MiRNA expression was correlated with chemotherapy-induced toxicities. Regression analyses was performed using SPSS v26.0. Results One hundred and one patients with median age of 55 years were recruited (range: 25–76). The mean tumour size was 36 mm and 60.4% had nodal involvement (n = 61) Overall, 33.7% of patients developed peripheral neuropathies (n = 34), 28.7% developed neutropenia (n = 29), and 5.9% developed anaemia (n = 6). Reduced miR-195 predicted patients likely to develop neutropenia (P = 0.048), while increased miR-10b predicted those likely to develop anaemia (P = 0.049). Increased miR-145 predicted those experiencing nausea and vomiting (P = 0.019), while decreased miR-21 predicted the development of mucositis (P = 0.008). Conclusion This is the first study which illustrates the value of measuring circulatory miRNA to predict patient-specific toxicities to NAC. These results support the ideology that circulatory miRNAs are biomarkers with utility in predicting chemotherapy toxicity as well as treatment response.

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“…As per American Society of Clinical Oncology guidelines (Allred score >2, or more than 1% stain positive), the ER status and PR status were determined independently by clinical pathologists, as per standard clinical breast pathology guidelines. 24 , 25 Human epidermal growth factor receptor-2 (HER2) receptor status was identified by Herceptest (DAKO Agilent Pathology Solutions, Santa Clara, CA), with a score of 3+ considered to be positive. Any 2+ inconclusive results were confirmed using fluorescent in situ hybridization testing, as per American Society of Clinical Oncology guidelines, with a HER2/CEP17 > 2.0 considered amplified.…”

Section: Methodsmentioning

confidence: 99%

Evaluating the Role of Circulating MicroRNAs in Predicting Long-Term Survival Outcomes in Breast Cancer: A Prospective, Multicenter Clinical Trial

Davey

McGuire

Casey

et al. 2022

Journal of the American College of Surgeons

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BACKGROUND: While long-term outcomes have improved for patients with breast cancer, 20% to 30% will still develop recurrence, and identifying these patients remains a challenge. MicroRNAs (miRNAs) are small, noncoding molecules that modulate genetic expression and affect oncogenesis. STUDY DESIGN: This prospective, multicenter trial (ICORG10/11-NCT01722851) recruited patients undergoing neoadjuvant chemotherapy across 8 Irish centers. Predetermined miRNAs were quantified from patient whole blood using quantitative reverse transcriptase polymerase chain reaction. Venous sampling was performed at diagnosis (timepoint 1) and midway during neoadjuvant chemotherapy (timepoint 2 [T2]). miRNA expression profiles were correlated with recurrence-free survival (RFS), disease-free survival (DFS), and overall survival. Data analysis was performed using R v3.2.3. RESULTS: A total of 124 patients were recruited with a median age of 55.0 years. The median follow-up was 103.1 months. Increased miR-145 expression at T2 was associated with improved RFS (hazard ratio 0.00; 95% confidence interval [CI] 0.00 to 0.99; p = 0.050). Using survival regression tree analysis, a relative cutoff of increased miR-145 expression greater than 0.222 was associated with improved RFS (p = 0.041). Increased miR-145 expression at T2 trended towards significance in predicting improved DFS (hazard ratio 0.00; 95% CI 0.00 to 1.42; p = 0.067). Using survival regression tree analysis, a relative cutoff of increased miR-145 expression greater than 0.222 was associated with improved DFS (p = 0.012). No miRNAs correlated with overall survival. CONCLUSIONs: ICORG10/11 is the first Irish multicenter, translational research trial evaluating circulatory miRNAs as biomarkers predictive of long-term survival and correlated increased miR-145 expression with enhanced outcomes in early-stage breast cancer. Validation of these findings is required in the next generation of translational research trials.

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What to Expect From the New ASCO/CAP Guideline Recommendations for Hormone Receptor Testing in Breast Cancer: A National Reference Laboratory Experience

Cited by 6 publications

References 18 publications

Evaluating the Role of Circulating MicroRNAs to Aid Therapeutic Decision Making for Neoadjuvant Chemotherapy in Breast Cancer

Evaluating the Role of Circulating MicroRNAs to Aid Therapeutic Decision Making for Neoadjuvant Chemotherapy in Breast Cancer

Circulating microRNAs can predict chemotherapy-induced toxicities in patients being treated for primary breast cancer

Evaluating the Role of Circulating MicroRNAs in Predicting Long-Term Survival Outcomes in Breast Cancer: A Prospective, Multicenter Clinical Trial

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