Gene signature evaluation as a prognostic tool: Challenges in the design of the MINDACT trial

Jan Bogaerts, Fatima Cardoso*, Marc Buyse, Sofia Braga, Sherene Loi, Jillian A. Harrison, Jacques Bines, Stella Mook, Nuria Decker, Peter Ravdin, Patrick Therasse, Emiel Rutgers, Laura J. van't Veer, Martine Piccart

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

215 Citations (Scopus)

Abstract

This Review describes the work conducted by the TRANSBIG consortium in the development of the MINDACT (Microarray In Node negative Disease may Avoid ChemoTherapy) trial. The goal of the trial is to provide definitive evidence regarding the clinical relevance of the 70-gene prognosis signature, and to assess the performance of this signature compared with that of traditional prognostic indicators for assigning adjuvant chemotherapy to patients with node-negative breast cancer. We outline the background work and the key questions in node-negative early-stage breast cancer, and then focus on the MINDACT trial design and statistical considerations. The challenges inherent in this trial in terms of logistics, implementation and interpretation of the results are also discussed. We hope that this article will trigger further discussion about the difficulties of setting up and analyzing trials aimed at establishing the worth of new methods for better selection of patients for cancer treatment.

Original languageEnglish
Pages (from-to)540-551
Number of pages12
JournalNature clinical practice oncology
Volume3
Issue number10
DOIs
Publication statusPublished - Oct 2006
Externally publishedYes

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