Kefah Mokbel: Can We Predict Who Needs Radiation Therapy after Lumpectomy for DCIS?
Kefah Mokbel, Chair of Breast Cancer Surgery at The London Breast Institute, shared a post on LinkedIn:
“Can we predict who needs radiation therapy after lumpectomy for DCIS ?
This observational study supports optimizing de-escalation/escalation treatment strategies for DCIS, the 7-gene biosignature reliably discriminated a low-risk group without significant RT benefit compared to CP factors alone and an elevated risk group that benefitted from RT, facilitating improved shared decision making. A randomized clinical trial (NRG CC-016) will provide Level 1A evidence for the impact of RT treatment on IBR rates for patients in the 7-gene biosignature Low Risk group, including those with CP high-risk.
The 7-gene biosignature used in the DCISionRT test (PreludeDx) measures the expression of seven protein biomarkers – including p16, Ki‑67, COX‑2, ER, HER2, and others related to proliferation and hormone signaling – combined with four clinicopathologic factors (age, tumor size, palpability, margins) to generate a Decision Score. This score predicts 10-year ipsilateral breast recurrence risk and the benefit of radiotherapy in patients with DCIS.
Limitations in the Application of Clinicopathologic Factors Alone in Predicting Radiation Benefit for Women with Low-Risk Ductal Carcinoma in Situ after Breast Conserving Surgery: The Impact of a 7-gene Biosignature based on 10-Year Ipsilateral Breast Recurrence (IBR) Rates – International Journal of Radiation Oncology, Biology, Physics”
Title: Limitations in the Application of Clinicopathologic Factors Alone in Predicting Radiation Benefit for Women with Low-Risk Ductal Carcinoma in Situ after Breast Conserving Surgery: The Impact of a 7-gene Biosignature based on 10-Year Ipsilateral Breast Recurrence (IBR) Rates
Authors: Frank Vicini, Chirag Shah, Karuna Mittal, Sheila Weinmann, Michael Leo, G Bruce Mann, Fredrik Warnberg, Rachel Rabinovitch, Brian Czerniecki, Icro Meattini, Atif Jalees Khan, Sachin Jhawar, Naamit Gerber, Shawna C. Willey, Pat Borgen, Zahraa AlHilli, Megan Kruse, David Dabbs, Steven C. Shivers, Anna Daily, Pat Whitworth, Michael Alvarado, Jason A. Mouabbi, Meena Moran, Hope Rugo, Joyce A. O’Shaughnessy, Troy Bremer
You can read the Full Article in the International Journal of Radiation Oncology, Biology, Physics.
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