Use of Multigene Prognostic Indices to Guide Clinical Decision-Making Regarding Adjuvant Systemic Therapy

Purpose of Review: Several multigene assays have been developed to guide adjuvant therapy decisions for early-stage invasive breast cancer, including the 21-gene recurrence score, 70-gene assay, EndoPredict, PAM50 Risk of Recurrence, and Breast Cancer Index. Recent Findings: Each assay has varying levels of evidence to support the analytical validity, clinical validity, and clinical utility in providing prognostic information complementary to conventional clinical characteristics. While each test is able to identify patients at low risk of distant recurrence, understanding the differences in development and studies used for clinical validation is important for guiding test selection for each unique patient. Summary: We provide an in depth analysis on each of these commercially available multigene tests to help providers determine which test may be most useful in a particular clinical context.