Steven Buechler Discusses EarlyR Gene Signature in the BIG 1-98 Trial for Breast Cancer

Steven Buechler, PhD, Department of Applied and Computational Mathematics and Statistics at the University of Notre Dame, discusses independent validation of the EarlyR gene signature in the Breast International Group (BIG) 1-98 study. This randomized, double-blind, phase III trial compared letrozole with tamoxifen as an adjuvant endocrine therapy for postmenopausal women with hormone receptor-positive, early breast cancer.

Although many patients in the BIG 1-98 trial demonstrated positive outcomes, Buechler says that there is still a small set of very high-risk patients who are ER-positive who could benefit from more aggressive therapy. These are patients who are likely to have a recurrence, so the side effects from a taxane-based chemotherapy regimen are worth the risk, says Buechler.

Many high-risk patients have amplification in chromosome 8 where the MYC gene is. MYC amplification has been associated with taxane sensitivity. Therefore, genomic data suggest that a taxane may be effective.