Post-treatment breast cancer prognosis

Abstract

The disclosure includes the identification and use of gene expression profiles, or patterns, with clinical relevance to extended treatment and cancer-free survival in a patient. In particular, the disclosure includes the identities of genes that are expressed in correlation with benefit in a switch in endocrine therapy used to treat a patient. The levels of gene expression are disclosed as a molecular index for predicting clinical outcome, and so prognosis, for the patient. The disclosure further includes methods for predicting cancer recurrence, and / or predicting occurrence of metastatic cancer, after initial treatment with an anti-estrogen agent. The disclosure further includes methods for determining or selecting the treatment of a subject based upon the likelihood of life expectancy, cancer recurrence, and / or cancer metastasis.

Description

RELATED APPLICATIONS[0001]This application is a continuation of PCT Application PCT / US2011 / 064290, filed Dec. 9, 2011 and published as WO 2012 / 079059 with designation of the U.S., and which claims benefit of priority to U.S. Provisional Patent Application 61 / 421,627, filed Dec. 9, 2010, both of which is hereby incorporated by reference in their entireties as if fully set forth herein.[0002]This application is related to International Application No. PCT / US2008 / 075528, filed on Sep. 6, 2008 (published as WO 2009 / 108215 A1) with designation of the U.S., and to U.S. patent application Ser. No. 12 / 718,973, filed Mar. 6, 2010. Both applications are hereby incorporated by reference as if fully set forth herein.FIELD OF THE DISCLOSURE[0003]The disclosure relates to the identification and use of gene expression profiles, or patterns, with clinical relevance to breast cancer. In particular, the disclosure is based in part on the identities of genes that are expressed in correlation with the ...

AI Technical Summary

Benefits of technology

[0077]The disclosure also includes a method of determining prognosis and / or survival outcome by assaying for the expression patterns disclosed herein. So where subjective interpretation may have been previously used to determine the prognosis and / or treatment of cancer patients, this disclosure provides objective gene expression patterns, which may used alone or in combination with subjective criteria to provide a more accurate assessment of patient outcomes, including survival and the recurrence of cancer.

Problems solved by technology

Unfortunately, data from the field indicate that more than half of all breast cancer recurrences occur after five years of treatment with adjuvant tamoxifen.

But Goss et al. provided no means by which to predict which subjects, treated for five years with tamoxifen, would benefit from subsequent letrozole treatment.

Therefore, there was no means to direct letrozole treatment only to the subjects for whom a benefit is expected.

So letrozole treatment was applied to subjects for whom no benefit would have been expected, resulting in an overtreatment of the population of breast cancer-free subjects treated with for five years with tamoxifen.