Molecular Testing in Breast Cancer: An Oncologist’s Perspective

Medical oncologists try to tailor treatment to each individual woman’s cancer’s biologic and clinical features. These features determine the risk of relapse and drug sensitivity for early breast cancer and the prognosis and treatment options for late breast cancer. Gene expression tests, including OncotypeDx, MammaPrint, Prosigna, and BCI, attempt to measure factors such as ER activation and proliferation to provide estimates of prognosis and chemotherapy sensitivity in early ER-positive breast cancer. They each provide similar information, and clinical factors such as age, tumor size, and grade retain independent prognostic value. In metastatic breast cancer, circulating tumor cells (CTCs) are prognostic and can be used to detect mutation, but cannot be used currently to guide choice of chemotherapy. Ongoing trials are assessing the use of therapy based on mutations in CTCs or in tumor themselves.

Lecture Presenter
Adam L. Cohen, MD, MS
Adam L. Cohen, MD
Assistant Professor, Division of Oncology, Huntsman Cancer Institute and University of Utah School of Medicine
Adjunct Assistant Professor, Department of Neurosurgery, University of Utah School of Medicine

Adam Cohen, MD, is an Assistant Professor in the University of Utah's Division of Oncology in the Department of Medicine. He is a Huntsman Cancer Institute (HCI) investigator and a member of the Experimental Therapeutics program. His specialties are neuro-oncology, breast oncology and gynecologic cancers.

Dr. Cohen's research focuses on clinical trials with the goal of personalizing treatment decisions for brain and breast cancer. He uses large sets of data to study gene expression patterns related to therapy response. He also helps scientists at HCI and the University of Utah translate their lab findings into clinical trials.

He has been a researcher with the University of Utah since 2009. Dr. Cohen completed a oncology fellowship at HCI and served as chief fellow. Before HCI, Dr. Cohen was chief resident in the Department of Internal Medicine at Banner Good Samaritan Medical Center in Phoenix, Arizona. He received his medical degree from Harvard Medical School. He received his undergraduate degree from Harvard College and a Master's in Mathematics from University of Chicago.

Objectives

After this presentation, participants will be able to:

Understand how ER, PR, and HER2 testing are used in treatment decisions.
Recognize the options for genomic profiling of breast tumors.
Understand how genomic profiling is used in adjuvant treatment decisions.
Understand the potential roles for genomic profiling in metastatic treatment decisions.