Prediction of outcome and individualization of therapeutic strategies are challenging problems in oncology. Predictive parameters for response to hormonal treatment include the expression of hormone receptor, the extent and location of metastatic spread, disease-free interval, patient age, response to prior hormonal therapy, grading, and more recently, some molecular markers like the expression of HER-2/neu. The use of conventional statistics for prediction of response to hormonal treatment is limited by non-linearities and complex interactions between predictive factors. Modern computational mathematical models like artificial neural networks, entropy-based inductive algorithms or χ2 interaction detection algorithms can describe these interactions and generate classification models and decision structures. They can be used to predict the clinical outcome for individual patients. In contrast to conventional methods, the level of confidence for the predictions can reach 90% and more. This might be an important step towards further individualization of therapeutic strategies.

1.
Sedlacek SM, Horowitz KB: The role of progestins and progesterone receptors in the treatment of breast cancer. Steroids 1994;44:467–484.
2.
Spataro V, Price K, Goldhirsch A, Cavalli F, Simoncini E, Castiglione M, Rudenstam CM, Collins J, Lindtner J, Gelber RD: Sequential estrogen receptor determination from primary breast cancer and at relapse: Prognostic and therapeutic relevance. The International Breast Cancer Study Group (formerly Ludwig Group). Ann Oncol 1992;3:733–740.
3.
Pichon MF, Broet P, Magdelenat H, Delarue JC, Spyratos F, Basuyau JP, Saez S, Rallet A, Courriere P, Millon R, Asselain B: Prognostic value of steroid receptors after long-term follow-up of 2,257 operable breast cancers. Br J Cancer 1996;73:1545–1551.
4.
Broet P, Pichon MF, Magdelenat H, Delarue JC, Spyratos F, Basuyau JP, Saez S, Rallet A, Courriere P, Millon R, Asselain B: Long-term prognostic role of steroid receptors in cancer of the breast. Bull Cancer 1998;85:347–352.
5.
Wischnewsky MB, Schmid P, Böhm R, Chaudri HA, Possinger K: Who benefits most from second-line treatment with letrozole? In Miller WR, Santen RJ (eds): Aromatase Inhibition and Breast Cancer. New York, Dekker, 2000, pp 63–85.
6.
Ripley BD: Statistical aspects of neural networks; in Barndorff-Nielsen OE, et al (eds): Chaos and Networks – Statistical and Probabilistic Aspects. London, Chapman & Hall, 1993.
7.
Schmid P, Possinger K, Böhm R, Chaudri HA, Verbeek A, Grosse Y, Lüftner D, Petrides PE, Sezer O, Wischnewsky MB: Body mass index as predictive parameter for response and time to progression in advanced breast cancer patients treated with letrozole or megestrol acetate. Proc Am Soc Clin Oncol 2000;18:abstr 398.
8.
Possinger K, Schmid P, Böhm R, Chaudri HA, Sezer O, Wischnewsky MB: Letrozole in ABC patients with visceral metastases. Proc Am Soc Clin Oncol 2000;18:abstr 397.
9.
Wischnewsky MB, Schmid P, Böhm R, Chaudri HA, Grunewald R, Possinger K: Classification of patients with long times to treatment failure and overall survival having stable disease under second-line treatment with letrozole or MA. Proc Am Soc Clin Oncol 2000;18:abstr 508.
10.
Wischnewsky MB, Schmid P, Boehm R, Verbeek JA, Possinger K: Letrozole and megestrole acetate in patients with advanced breast cancer resistant to taxmoxifen. Breast Cancer Res Treat 2000;64:54.
11.
Possinger K, Schmid P, Wischnewsky MB: Letrozole is highly effective in patients with soft tissue metastases. Breast Cancer Res Treat 2000;64:53.
12.
Dombernowsky P, Smith I, Falkson G, Leonard R, Panasci L, Bellmunt J, Bezwoda W, Gardin G, Gudgeon A, Morgan M, Fornasiero A, Hoffmann W, Michel J, Hatschek T, Tjabbes T, Chaudri HA, Hornberger U, Trunet PF: Letrozole, a new oral aromatase inhibitor for advanced breast cancer: Double-blind randomized trial showing a dose effect and improved efficacy and tolerability compared with megestrol acetate. J Clin Oncol 1998;16:453–461.
13.
Gershanovich M, Chaudri HA, Campos D, Lurie H, Bonaventura A, Jeffrey M, Buzzi F, Bodrogi I, Ludwig H, Reichardt P, O’Higgins N, Romieu G, Friederich P, Lassus M: Letrozole, a new oral aromatase inhibitor: Randomised trial comparing 2.5 mg daily, 0.5 mg daily and aminoglutethimide in postmenopausal women with advanced breast cancer. Letrozole International Trial Group. Ann Oncol 1998;9:639–645.
14.
Wischnewsky MB, Schmid P, Possinger K: Self-organizing maps for data analysis and prediction of outcome in second-line hormonal treatment of metastatic breast cancer. Ann Oncol 2000;11(suppl 4):25.
15.
Schmid P, Possinger K, Wischnewsky MB: Self-organizing maps and prognosis of advanced breast cancer patients with bone metastases receiving letrozole or MA. Breast Cancer Res Treat 2000;64:77.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.