The Impact of Genomic Testing on mBC Treatment


Patrick I. Borgen, MD: One of the goals is to continue to refine and improve our patient selection. What you would love to do with accuracy is to predict the future in patients. Who is going to benefit from chemotherapy? Who is going to benefit from simply blocking estrogen? There are a variety of tools available that can help us compare clinical pathologic features to the Oncotype DX score to better select patients. That's where the field is going right now.

Historically, every patient got every treatment. If you had a 1 cm, node-negative breast cancer in the 1990s through the early 2000s, you got chemotherapy. This was the dawn of the era of dose-dense chemotherapy. Not only did you get chemotherapy, but you got big-gun chemotherapy. We know that we were treating a lot of patients to help a few. What genomic testing allows us to do is to match the treatment with the disease in the patient who's in front of us.

To minimize the adverse effects and to maximize the efficacy is the beauty and the art of genomic profiling. In the estrogen receptor-positive, HER2-negative space, the gold standard is the Oncotype DX. It's part of the staging system for breast cancer now. We rely on it very heavily, and I think it has changed practices. It has improved outcomes and the quality of patients' lives by reducing the long-term adverse effects that we saw from cytotoxic chemotherapy.

Transcript Edited for Clarity

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