Dr. Melisko Reflects on Findings From the MINDACT Trial in Breast Cancer

Michelle E. Melisko, MD
Published: Thursday, Oct 11, 2018



Michelle E. Melisko, MD, associate clinical professor, Department of Medicine, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, reflects on the findings from the MINDACT trial in breast cancer.

In light of the results from the TAILORx trial and its use of Oncotype DX, there is more attention being given to the evaluation of patients with breast cancer in clinical trials with genetic diagnostic tests. In 2016, the MINDACT trial verified MammaPrint as a clinically useful diagnostic tool in the treatment of patients with high-risk, node-positive, grade 3 breast cancer. The fact that MammaPrint looks at 70 genes and tumors in many different ways may give greater insight into the biology of the cancer, Melisko says.

In MINDACT, risk of tumor recurrence was assessed 2 ways—genetically through MammaPrint or clinically. The group of patients who were deemed clinically high risk but were categorized as low risk by MammaPrint were randomized to receive chemotherapy or not. Those who did not receive chemotherapy at 5 years had an almost 95% chance of being alive without distant metastases. The benefits of chemotherapy are often seen in the first 5 years, Melisko says, so any relapse that occurs beyond 5 years is most likely a failure of endocrine therapy.


Michelle E. Melisko, MD, associate clinical professor, Department of Medicine, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, reflects on the findings from the MINDACT trial in breast cancer.

In light of the results from the TAILORx trial and its use of Oncotype DX, there is more attention being given to the evaluation of patients with breast cancer in clinical trials with genetic diagnostic tests. In 2016, the MINDACT trial verified MammaPrint as a clinically useful diagnostic tool in the treatment of patients with high-risk, node-positive, grade 3 breast cancer. The fact that MammaPrint looks at 70 genes and tumors in many different ways may give greater insight into the biology of the cancer, Melisko says.

In MINDACT, risk of tumor recurrence was assessed 2 ways—genetically through MammaPrint or clinically. The group of patients who were deemed clinically high risk but were categorized as low risk by MammaPrint were randomized to receive chemotherapy or not. Those who did not receive chemotherapy at 5 years had an almost 95% chance of being alive without distant metastases. The benefits of chemotherapy are often seen in the first 5 years, Melisko says, so any relapse that occurs beyond 5 years is most likely a failure of endocrine therapy.



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