Genomic Testing in Breast Cancer: Clinical Applications and Best Practices - Episode 9
Leveraging Genomic Assays to Guide Treatment Decisions: Clinical Scenarios and Expert Perspectives
Panelists discuss how genomic testing informs real clinical scenarios, demonstrating that for a 64-year-old healthy woman with a single positive lymph node, the 21-gene assay would guide treatment decisions, with cardiac assessment influencing whether anthracycline-based chemotherapy would be used if her score was high.
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.
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