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Prognostics

Tailor-made therapy

Nature Reviews Cancer volume 2, page 157 (2002)Cite this article

In order to identify a gene-expression signature that could be used to predict disease outcome, the authors isolated RNA from 98 tumours of patients with lymph-node-negative, primary breast cancer. Microarray analysis revealed that 5,000 genes had significant alterations in expression level. An unsupervised cluster analysis — which grouped tumours according to their similarities over these 5,000 genes — then showed that the tumours fell into one of two groups, and that these could, to some extent, distinguish between tumours with a good prognosis and a bad prognosis.

In order to establish a more effective prognostic signature, tumours taken from 78 patients diagnosed with sporadic cancer — 44 of whom had remained disease free for at least 5 years and 34 of whom had developed distant metastases within 5 years — were subjected to a three-step supervised classification method. This allowed identification of 70 genes — the 'prognosis classifier' — that could correctly predict disease outcome in 83% of cases. However, when being used to select which patients should receive adjuvant therapy, it is important that the poor prognosis patients are diagnosed correctly, at a sacrifice of overall accuracy. Altering the threshold to achieve this aim reduced the number of tumours with a poor prognosis that were assigned to the wrong category to less than 10%.

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References

ORIGINAL RESEARCH PAPER

  1. van't Veer et al. Gene expression profiling predicts clinical cancer outcome of breast cancer. Nature 415, 530–536 (2002)

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FURTHER READING

  1. Caldas, C. & Aparicio, S. A. J. The molecular outlook. Nature 415, 484–485 (2002)

    Article  CAS  Google Scholar 

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Authors
  1. Emma Greenwood
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Greenwood, E. Tailor-made therapy. Nat Rev Cancer 2, 157 (2002). https://doi.org/10.1038/nrc754

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  • DOI: https://doi.org/10.1038/nrc754

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