Chemotherapy decision making in breast cancer

EndoPredict® Breast Cancer Prognostic Test predicts the individual chemotherapy benefit for women with ER positive/HER2 negative early-stage breast cancer, so confident treatment decisions can be made with each patient.

Information for clinicians

When to use adjuvant chemotherapy in breast cancer

EndoPredict is the only gene expression test providing 10 years’ personalized chemotherapy benefit for premenopausal AND postmenopausal women with early-stage breast cancer that is ER positive, HER2 negative, node negative or positive1-7 – and the only second generation test with level of evidence 1A data.8,9

Almost all women with ER positive/HER2 negative breast cancer will receive at least 5 years of endocrine therapy. But, the question of who will benefit from adjuvant chemotherapy is still challenging.

Clinicians and their patients can use EndoPredict as a prognostic tool for deciding breast cancer treatment, improving quality of life for more women with ER positive/HER2 negative early-stage breast cancer.

If you are a patient, please ask your doctor if the EndoPredict test is right for you, or visit our patient homepage for more information.

What are the benefits of chemotherapy for breast cancer patients?

Chemotherapy benefit was validated in a large cross-cohort study4 with over 3,700 patients with ER positive, HER2 negative breast cancer:

  • 2,630 breast cancer patients were treated with 5 years of endocrine therapy alone
  • 1,116 patients were treated with endocrine therapy plus chemotherapy with current treatment regimens

EndoPredict guides chemotherapy decisions for breast cancer patients

These data show clearly separated curves and an individual chemotherapy benefit for EPclin high-risk patients, which were proven by a significant test for interaction.

The EPclin Risk Score is calculated for every patient, presented as a continuous curve. The cut-off for low- and high-risk aligns with the 10% guideline-recommended, acceptable risk of breast cancer recurrence. Chemotherapy benefit at the cut-off is about 3%, roughly comparable to the risk of more serious side effects from chemotherapy.

Clinicians can confidently use each woman’s EPclin Risk Score to guide shared decision making with regards to treatment options. Learn how to interpret EPclin Risk Score.

Level of evidence 1A,9 and recommended in national and international guidelines

Validated in five prospective-retrospective studies of more than 3,500 patients.1-7 Initial results of a randomized controlled prospective phase III study (UNIRAD) were released at SABCS 2021.8

Recommended by many international and national guidelines, including ASCO, NCCN, AJCC, ESMO, St. Gallen, EGTM, AGO, HAS, NICE, SEOM, AIOM, CACA-CBCS, CcO.

How does the EndoPredict breast cancer test work?

The EndoPredict animated app can show you how various gene activities in the tumor influence the prognosis and how the molecular fingerprint and tumor size and nodal status contribute to the final EndoPredict result.

EndoPredict second generation test can be performed locally within a few days

EndoPredict Breast Cancer Prognostic Test is available to order by clinicians via numerous local labs in your country or outside of the EU also via Myriad Genetics’ central laboratory in Salt Lake City, USA.

References

  1. Filipits, Martin et al. “Prediction Of Distant Recurrence Using Endopredict Among Women With ER+, HER2− Node-Positive And Node-Negative Breast Cancer Treated With Endocrine Therapy Only“. Clinical Cancer Research, vol 25, no. 13, 2019, pp. 3865-3872
  2. Filipits, Martin et al. “A New Molecular Predictor Of Distant Recurrence In ER-Positive, HER2-Negative Breast Cancer Adds Independent Information To Conventional Clinical Risk Factors“. Clinical Cancer Research, vol 17, no. 18, 2011, pp. 6012-6020
  3. Buus, Richard et al. “Comparison Of Endopredict And Epclin With Oncotype DX Recurrence Score For Prediction Of Risk Of Distant Recurrence After Endocrine Therapy“. Journal Of The National Cancer Institute, vol 108, no. 11, 2016, p. djw149
  4. Sestak, Ivana et al. “Prediction Of Chemotherapy Benefit By Endopredict In Patients With Breast Cancer Who Received Adjuvant Endocrine Therapy Plus Chemotherapy Or Endocrine Therapy Alone“. Breast Cancer Research And Treatment, vol 176, no. 2, 2019, pp. 377-386
  5. Constantinidou, Anastasia, et al. “Clinical Validation of EndoPredict in Pre-Menopausal Women with ER-Positive, HER2-Negative Primary Breast Cancer”. Clinical Cancer Research, vol. 28, no. 20, 2022, pp. 4435–4443
  6. Martin, Miguel et al. “Clinical Validation Of The Endopredict Test In Node-Positive, Chemotherapy-Treated ER+/HER2− Breast Cancer Patients: Results From The GEICAM 9906 Trial“. Breast Cancer Research, vol 16, no. 2, 2014, p. R38
  7. Dubsky, Peter et al. “The Endopredict Score Provides Prognostic Information On Late Distant Metastases In ER+/HER2− Breast Cancer Patients“. British Journal Of Cancer, vol 109, no. 12, 2013, pp. 2959-2964
  8. Penault-Llorca, Frederique et al. “Prognostic value of EndoPredict test in patients screened for UNIRAD, a UCBG randomized, double blind, phase III international trial evaluating the addition of *** (EVE) to adjuvant hormone therapy (HT) in women with high risk HR+, HER2- early breast cancer (eBC)“. SABCS 2021, PD-09-08 Spotlight Poster Discussion 9
  9. Simon, Richard et al. “Use Of Archived Specimens In Evaluation Of Prognostic And Predictive Biomarkers”. Journal Of The National Cancer Institute, vol 101, no. 21, 2009, pp. 1446-1452