Molecular profiling forecasts breast ca outcomes. (Broad New Epoch in Medicine).

SAN ANTONIO -- The recent successful demonstration that molecular profiling markedly improves prediction of outcome in breast cancer signals the beginning of a broad new epoch in medicine, Dr. Stephen H. Friend said at a breast cancer symposium sponsored by the San Antonio Cancer Institute.

The same DNA microchip analysis methods shown to forecast clinical outcome of breast cancer better than any conventional criteria will also enable physicians to tailor therapies to fit a patient's specific disease subtype. Diagnosis and treatment will become integrated in a new way. And the change is coming soon.

"I think it's quite likely that for all types of tumors--and we're working with a number of different cancers now in addition to breast cancer--the concept of running a clinical trial without molecular profiling of the tumor will be a thing of the past within a year or two," predicted Dr. Friend, president and CEO of Kirkland, Wash.-based Rosetta Inpharmatics and vice president of basic research at Merck & Co., which owns the molecular profiling company.

Molecular profiling, whether done using gene chips or protein arrays, employs high-speed computers and pattern recognition to analyze what's going on within a cell. The amount of information extracted in this fashion dwarfs that obtainable via the handful of individual prognostic markers traditionally used in breast cancer, such as patient age, estrogen receptor status, tumor size and histology and axillary node status.

The need for better prognostic tools arises from the fact that some patients fare poorly despite having what appears to be a favorable-prognosis breast rumor based upon conventional prognostic markers. As a result, systemic therapy is currently recommended for roughly 90% of young patients ...