From: Molecular and gene expression-based predictors of response to preoperative chemotherapy
Reference | Patient characteristics | Treatment | Results |
---|---|---|---|
Chang et al. [1] | 24 (discovery) and 6 (validation) patients. with LABC | 4 cycles docetaxel every 3 weeks | 92 differentially expressed genes (P < 0.001) LOOCV results in training: predictive accuracy of 88% (95% CI, 68–97%), PPV of 92%, NPV of 83%, sensitivity of 85% (95% CI, 55–98%), specificity of 91% (95% CI, 59–100%) |
 |  |  | Independent validation: all six patients with sensitive tumors correctly identified |
Ayers et al. [2] | 24 (discovery) and 12 (validation) patients with breast cancer | 3 or 12 cycles paclitaxel and 4 cycles of FAC (T/FAC) | No single gene sufficiently associated with pCR to serve as single valid marker 74-gene predictor for response to chemotherapy |
 |  |  | - Predictive accuracy of 78% (95% CI, 52–94%), PPV of 100% (95% CI, 29–100%), NPV of 73% (95% CI, 45–92%), sensitivity of 43% (95% CI, 10–82%), specificity of 100% (95% CI, 72–100%) |
Iwao-Koizumi et al. [3] | 44 (discovery) and 26 (validation) patients. with stage II/IV breast cancer | 4 cycles of docetaxel | 85-gene-predictor of pCR with: |
 |  |  | - Predictive accuracy of 80.7% (95% CI, 63.5–92.5%), PPV of 73.3% (95% CI, 49.5–90.3%), NPV of 90.9% (95% CI, 65.9–99.4%), sensitivity of 91.7% (95% CI, 68.1–99.5%), specificity of 71.4% (95% CI, 46.7–89.5%) |
Hannemann et al. [4] | 48 patients with LABC | 6 cycles of doxorubicin/docetaxel (AD, n = 24) or doxorubicin/cyclophosphamide (AC, n = 24) | No differentially expressed genes identified, no possible multigene predictor developed |
 |  |  | Patient samples did not cluster distinctly for pCR/near pCR compared with RD in hierarchical clustering |
Gianni et al. [5] | 89 (INT-Milan) and 82 (MDACC) patients with LABC | 3 cycles of doxorubicin/paclitaxel, 12 cycles of weekly paclitaxel | 86 genes correlating with pCR (P < 0.05) forming three clusters |
 |  |  | - ER gene cluster |
 |  |  | - Proliferation gene cluster |
 |  |  | - Immune-related gene cluster |
 |  |  | RS correlated with pCR in INT-Milan patients 86-gene model developed on INT-Milan patients validated on MDACC samples |
Folgueira et al. [6] | (1) 38 (discovery), 13 (validation) | Â | (1) 25 (3.8%) differentially expressed transcripts between responders and non-responders, three-gene classifier could not be validated |
 | (2) 31 (discovery), 13 (validation) |  | (2) Three-gene classifier successfully developed and validated both by LOOCV and in an independent validation set |
Dressman et al. [7] | 37 patients with stage IIB/III breast cancer | Liposomal doxorubicin × 4/paclitaxel combined with local whole breast hyperthermia | (a) 22-gene signature characterizing IBC identified and validated by LOOVC |
 |  |  | (b) 18-gene signature characterizing IBC identified and validated by LOOVC |
 |  |  | (c) No gene signature predicting clinical response could be identified |
Thuerigen et al. [8] | 52 (discovery/GEsDoc), 48 (validation/GEDoc) patients with T2-4N0-2M0 breast cancer | GEsDoc (gemcitabine, epirubicin every 2 weeks × 5 followed by docetaxel every 2 weeks × 2), GEDoc (gemcitabine, epirubicin, docetaxel every 3 weeks) | 512-gene-signature predictive of pCR: predictive accuracy of 88% (95% CI, 75–95%), PPV of 64% (95% CI, 39–81%), NPV of 95% (95% CI, 82–99%), sensitivity of 78% (95% CI, 40–97%), specificity of 90% (95% CI, 76–97%) |
Park et al. [9] | 21 patients with stage II/III breast cancer | 4 cycles of FEC every 3 weeks followed by 12 cycles of weekly paclitaxel | 11 differentially expressed ABC transporters Multigene predictor model with the ABC transporters differentially expressed between the two classes (P < 0.003) with predictive of pCR with: |
 |  |  | - Predictive accuracy of 92.8% (95% CI, 88.0–97.4%), PPV of 93.2% (95% CI, 85.2–100%), NPV of 93.6% (95% CI, 87.8–99.4%), sensitivity of 88.1% (95% CI, 76.8–99.4%), specificity of 95.9% (95% CI, 87.8–100%) |
Cleator et al. [10] | 40 patients with primary breast cancer | 6 cycles doxorubicin/cyclophosphamide (AC) | 253 differentially expressed genes; |
 |  |  | - 75 genes overexpressed in resistant tumors (that is, transcription, differentiation, signal transduction, amino acid metabolism) |
 |  |  | - 178 genes overexpressed in sensitive tumors (that is, cell cycle, survival, stress response, and estrogen-regulated genes) |
Hess et al. [11] | 82 (discovery), 51 (validation) | 3 or 12 cycles paclitaxel and 4 cycles of FAC (T/FAC) | 30-gene predictor identified and validated by fivefold cross-validation, permutation testing and application to an independent data set: |
 |  |  | - Predictive accuracy of 76% (95% CI, 62–87%), PPV of 52% (95% CI, 31–73%), NPV of 96% (95% CI, 82–100%), sensitivity of 92% (95% CI, 64–100%), specificity of 71% (95% CI, 54–85%) |
Mina et al. [12] | 45 patients with stage II/III breast cancer | 3 cycles doxorubicin every 2 weeks and 6 cycles docetaxel weekly × 6 | 22 of 274 candidate genes correlated with pCR (P < 0.05) forming three large clusters: angiogenesis-related genes, proliferation-related genes, invasion-related genes, no correlation between RS and pCR, 24/274 genes correlated with inflammatory phenotype |