A new study from Agendia, Irvine, Calif, a precision oncology company specializing in breast cancer, shows that genomic profiling with the company’s BluePrint and MammaPrint assays can help determine the best course of treatment for African-American women.1 The study suggests that BluePrint and MammaPrint can help characterize a tumor’s biology and the possible prognosis for select patients independent of genetic ancestry. The prognosis can be for either low- or high-risk patients.
African-American women with breast cancer typically have a less favorable prognosis overall than Caucasian women. Numerous factors account for this state of affairs, including well-established health disparities and differences in tumor biology. MammaPrint is a prognostic and predictive test for early-stage breast cancer that analyzes the 70 most important genes associated with cancer recurrence in order to classify each patient as low-risk or high-risk for developing metastases within the first 10 years after diagnosis. The study shows:
- African-American patients had a higher likelihood of having higher grade, ER–, LN+ tumors than Caucasian women.
- MammaPrint identified patients with low-risk outcomes, irrespective of race.
- In multivariate analysis, race was a significant factor for higher pathological complete response rates to neoadjuvant chemotherapy in African-American compared with Caucasian patients, together with PR, HER2, T-stage, and grade (HR = 1.679, 95% CI = (1.057, 2.67), p = 0.028).
“The findings in this study add important new observations to the prior research with MammaPrint regarding the biologic characteristics of breast cancer in African-American women,” says William Audeh, MD, medical oncologist and chief medical officer of Agendia. “Molecular subtyping with BluePrint in African-American women, compared with Caucasian women, found different proportions of Luminal A, Luminal B, HER2, and Basal type cancers.
“Most important, however, MammaPrint identification of low- or high-risk outcomes and Blueprint ability to classify subtypes were the same, regardless of African-American or Caucasian ancestry,” Audeh says. “Unlike other assays, MammaPrint and BluePrint identify critical aspects of tumor biology with universal application and consistent interpretation for all women with breast cancer. These data show that through genomic profiling, we now have the ability to predict and identify how a tumor might respond to treatment to drive better outcomes for all patients with breast cancer.”
A previous study—the neoadjuvant breast cancer symphony trial (NBRST)—was a prospective trial that showed an association of MammaPrint and BluePrint with a pathological complete response rate of 2% in Luminal A cancers with a 95% distant metastasis-free interval at 3 years. The new study provides data on the risk distribution, response to therapy, and outcomes among African-American and Caucasian women. The study also confirms that racial differences in gene expression are a factor in the survival disparity observed between African-American and Caucasian women with breast cancer.
For more information, visit Agendia.
- Nunes R, DeSnoo F, Stork-Sloots L, et al. Race and response to neoadjuvant chemotherapy according to MammaPrint risk [abstract, online]. Poster presented at the 2019 annual meeting of the American Society of Clinical Oncology, Chicago, May 31–June 4, 2019. J Clin Oncol. 2019;37(suppl):abstract 578. Available at: https://abstracts.asco.org/239/AbstView_239_261535.html. Accessed September 1, 2019.