Multigene Panel Testing in Breast Cancer

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Multigene assays have been utilized to profile genes to identify molecular drivers of cancer and appropriate targeted therapies. At this point, several companies offering multigene panel assessment, using next-generation sequencing. Additionally, many cancer centers are developing their own 400-gene panels, which can be used to guide patients to appropriate clinical trials and emerging therapies.

More often than not, the molecular information obtained from a multigene panel cannot be readily utilized, since a necessary drug may not exist, explains Carlos L. Arteaga, MD. The primary utility of Foundation Medicine’s and similar multigene assays is to triage patients to clinical trials, concurs Debu Tripathy, MD. Readouts may occasionally identify a PI3-kinase mutation that allows clinicians to consider using an mTOR inhibitor, but without firm data at this point, Tripathy says that assay results must be interpreted with caution.

Another challenge in disease management is access to agents, explains Joyce O’Shaughnessy, MD, citing a need for better coverage of medications for exceptional responders.