Lost in translation—prognostic signatures for breast cancer
Lajos Pusztai
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The number of prognostic gene signatures reported for breast cancer has increased dramatically in the past 5 years. The use of genomic prognostic assays, however, remains low, both in routine practice and in clinical trials. Currently, there are three commercially available genomic prognostic assays: Oncotype DX®, MammaPrint®, and H/I®. Only the Oncotype DX® assay is used frequently in routine practice, although the other two assays were only recently introduced to the market. In addition, there are only two ongoing randomized clinical trials in breast cancer that use genomic assays for risk stratification: TAILORx and MINDACT. This situation might be considered reminiscent of the single-gene prognostic marker research field, where thousands of manuscripts were published over several decades but only three biomarkers, namely PR, ER, and HER2 were, and are still, used in the clinic routinely.
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