Ninez Ponce, associate Center director, is senior author of a new fact sheet about the use of gene expression profiling, a genomic test that scores an early-stage breast cancer patient's risk of cancer recurrence. In this brief interview, she discusses the test, how test results can be used, and gaps in who receives the test.
Q: What is a gene expression profile and why are cancer patients given the test?
A gene expression profile (GEP) is a test that estimates the activity of specific genes in cancer cells that can influence how likely a cancer is to grow and how likely it is to respond to treatment. GEP helps patients decide whether their treatment should include chemotherapy or not. Generally, patients with a high GEP score are at high risk of recurrence and should receive chemo. A low GEP score indicates low risk where chemo would not be beneficial. GEP is widely recommended by doctors and is covered by most health insurance.
Q: Your fact sheet says that 90 percent of patients at low risk or at high risk received care as recommended by the genomic test. That's a high success rate -- can it be improved?
We found that the majority of the women received treatment as recommended by the test, and it is great news. However, efforts are still needed in communicating the test result to patients: One in five women did not know the results of her test, whether she was at low risk or high risk for breast cancer recurrence. Armed with test results, women can have a better discussion with their doctors about treatment options and follow-up care.
Q: Of the seven percent of low-risk women who are getting unnecessary chemotherapy, are there certain groups who are more affected?
The 7 percent figure is for the group of women as a whole. But our survey showed low-risk Latino and African-American women were more frequently getting chemotherapy, 15 percent and 11 percent respectively, compared to 7 percent of whites and 2 percent of Asians.
No matter what the percentage, we should aim for helping all low-risk patients weigh the physical and financial costs and benefits of chemotherapy by giving them the information to talk to their doctors and make sound decisions about their treatment.
Additional Information
The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health and affiliated with the UCLA Luskin School of Public Affairs.