Use of prognostic gene expression profiling tests in primary breast cancer treatment: a German real-world patient survey

• Published in: Future oncology (London, England) Vol. 18; no. 39; pp. 4371 - 4383
• Main Authors: Messinger, David, Bleß, Hans-Holger, Haidinger, Renate, Schumacher-Wulf, Eva, Lux, Michael Patrick
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.12.2022
• Subjects: adjuvant chemotherapy; Breast Neoplasms - diagnosis; Breast Neoplasms - drug therapy; Breast Neoplasms - genetics; Chemotherapy, Adjuvant; Female; Gene Expression Profiling; Germany; Humans; primary breast cancer; primary breast carcinoma; Prognosis; prognostic testing; real-world; shared decision-making; Surveys and Questionnaires; treatment decision; adjuvant chemotherapy; real-world; primary breast cancer; primary breast carcinoma; treatment decision; shared decision-making; prognostic testing; gene expression profiling; Germany
• ISSN: 1479-6694; 1744-8301
• DOI: 10.2217/fon-2022-0354

In primary breast cancer, gene expression profiling tests can support adjuvant chemotherapy treatment decisions. Real-world test use in Germany was investigated in an online survey of female breast cancer patients (n = 475). Relationships between three groups were examined for clinical and statistical relevance: no test indication (n = 353), test indication and tested (n = 65) and test indication but not tested (n = 57). A total of 47% of participants with a test indication were not tested. Test rates increased by 23% from 2012–2018 (49%) to 2019–2021 (60%). A total of 65% of patients without testing received chemotherapy, whereas only 38% of tested patients received chemotherapy. The use of gene expression profiling tests correlates with a real-world chemotherapy reduction. Gene expression profiling testing may improve patient confidence in the decision for or against chemotherapy. In many cases, breast cancer can be removed by surgery. In addition to surgery, breast cancer patients may also receive chemotherapy; however, chemotherapy is not always useful. A gene expression profiling test can help physicians and patients decide if chemotherapy should be used. In a survey, 475 breast cancer patients in Germany were asked if they received such a test and chemotherapy. A total of 65% of patients who were not tested received chemotherapy compared with 38% of patients who were tested. Patients who received a test also felt more certain about their treatment decision. However, four of ten patients who were diagnosed between 2019 and 2021 and for whom a test would have helped in the treatment decision did not receive a test. Therefore, there is still room to increase the use of gene expression profiling tests for the benefit of breast cancer patients in Germany.