Leveraging Genomic Assays to Guide Treatment Decisions: Clinical Scenarios and Expert Perspectives

Evolving Paradigms and Future Directions

Main Discussion Topics:

• Changing patterns in breast cancer mortality by stage at diagnosis
• Challenges in identifying high-risk early-stage patients
• Future directions for research and treatment optimization

Key Points for Physicians:

• Research findings show that 62% of patients who died from breast cancer in 2017 initially presented with stage I-II disease.
• Current research focuses on identifying early-stage patients who need more aggressive treatment.
• Questions remain about optimal treatment approaches (anthracyclines vs CDK4/6 inhibitors).

Notable Insights:

• The proportional risk reduction from current treatments has been greater for stage III-IV disease than for stage I-II disease.
• Clinical trial design faces challenges in asking the right questions rather than simply adding therapies.

Clinical Significance: Despite progress in breast cancer treatment, a significant unmet need remains in identifying and effectively treating early-stage patients at highest risk for recurrence and mortality.