Cmar_a_221676 10353..10373

1Department of Medical Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 2Department of Pathology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 3INSERM U1194 – Institut de Recherche en Cancérologie de Montpellier (IRCM), Montpellier, France; 4University of Montpellier, Montpellier, France; 5Department of Surgery, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 6Department of Radiation Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France Abstract: The decision to administer adjuvant chemotherapy in treatment of early invasive breast cancer (EBC) is often complex, particularly for hormone receptor-positive (HR+) diseases, and current guidelines often classify these patients in an intermediate-risk group. Several biomarkers are currently available in this indication, in order to obtain additional and more accurate prognostic information compared to classic clinicopathological characteristics and guide the indication of adjuvant chemotherapy, optimizing the efficacy/toxicity ratio. We conducted a systematic review to evaluate the clinical validity and clinical utility of five biomarkers (uPA/PAI-1, OncotypeDX, MammaPrint, PAM50, and EndoPredict) in HR +/HER2EBC, whatever the nodal status. A total of 89 studies met the inclusion criteria. Even though data currently available confirm the clinical validity of these biomarkers, there is a lack of data regarding clinical utility for most of them. Prospective studies in welldefined populations are needed to integrate these biomarkers in a decision strategy.