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Background Limited data exist on the real-world costs of applying whole-genome analysis ( WGA) in a clinical setting. We estimated the costs of applying WGA to guide treatments for patients with advanced cancers and characterized how costs evolve over time. Methods The setting is the British Columbia Cancer Agency Personalized OncoGenomics ( POG) program in British Columbia, Canada. Cost data were obtained for patients who enrolled in the program from 2012 to 2015. We estimated mean WGA costs using bootstrapping. We applied time series analysis and produced 10-year forecasts to determine when costs are expected to reach critical thresholds. Results The mean cost of WGA over the study period was CDN$34,886 per patient (95% CI: $34,051, $35,721). Over time, WGA costs decreased, driven by a reduction in costs of sequencing. Yet, costs of other components of WGA increased. Forecasting showed WGA costs may not reach critical thresholds within the next 10 years. Conclusion WGA costs decreased over the studied time horizon, but expenditures needed to realize WGA remain significant. Future research exploring costs and benefits of WGA-guided cancer care are crucial to guide health policy. [ABSTRACT FROM AUTHOR]

Aims Recent evidence indicates that weakly positive immunohistochemical staining of oestrogen receptor ( ER) is not associated reliably with a luminal subtype, with the majority reclassified as basal-like by gene expression profile. In this study we assessed the capacity of recently identified immunohistochemical markers of basal-like subtype not dependent upon ER status - positive expression of nestin or loss of inositol polyphosphate-4-phosphatase ( INPP4b) - to discriminate intrinsic subtypes, focusing on clinically problematic cases with weak ER positivity. Methods and results Formalin-fixed paraffin-embedded blocks, enriched for large proportions of ER-negative and ER weakly positive breast cancers, were selected from two previous studies conducted in the period 2008-13 and used for (i) RNA extraction for 50-gene subtype predictor ( PAM50) intrinsic subtyping and (ii) tissue microarray construction for immunohistochemical assessment of nestin and INPP4b. Fifty-eight cases were weakly positive for ER (Allred 3-5), among which 28 (48%) were assigned as basal-like by PAM50 gene expression. In these 58 cases, the nestin/ INPP4b panel identified 23 basal-like cases with a positive predictive value of 87% [95% confidence interval (CI) 78-95%] and excluded luminal subtype with a negative predictive value of 95% (95% CI 88-100%). Weakly positive ER patients assigned as basal-like by nestin/INPP4b definition demonstrated a median survival time of 45.8 months, significantly lower than 65 months among other ER weakly positive cases ( P = 0.012). Conclusions Immunohistochemical assessment of nestin and INPP4b provides an accurate, accessible and inexpensive tool to identify basal-like breast cancer subtype in the clinically problematic setting of weak ER positivity. This panel identifies poor prognosis patients who might need strong considerations for non-endocrine-based therapies. [ABSTRACT FROM AUTHOR]

The article discusses research being done on the risk of early recurrence among postmenopausal women with estrogen-positive early breast cancer treated with adjuvant tamoxifen. It references a study by Hagen Kennecke et al, published in the 2008 issue of "Cancer." It was found that subgroups of women with early estrogen-receptor (ER)-positive breast cancer may be identified who are at increased risk of recurrence within 2.5 years of diagnosis in spite of tamoxifen.

The article presents a study which assessed the impact on survival of population-based access to new agents for the treatment of metastatic breast cancer (MBC). In the study, all patients with a first diagnosis of distant metastases in each of the time cohorts were identified and characterized, and their survival was compared. The results showed that survival in Cohort 1 and Cohort 2 was similar but survival was longer in Cohort 3.