Genexpressionsbasierte risikoscores: Besser als histopathologische marker?

The decoding of the human genome and its targeted analysis using different techniques has raised great hopes encompassing improvement in the estimation of prognosis and prediction of treatment as well as the identification of new therapeutic targets. The gene expression analysis and identification of appropriate predictive and/or prognostic gene expression signatures is a paradigm for this process. Great expectations have been placed on these new molecular markers, however, there are numerous meth-odological and clinical questions which need to be determined in prospective, randomized studies but which are currently in the recruiting stage. It is very much the question as to whether the new gene expression-based risk scores will bring any information gain in com-parison to classical histopathology markers. However, these studies also begin to show that not only the identification of a high risk subgroup, but also reducing the risk by a specific treatment is possible. As yet it is not clear whether the practical application of this test system will actually be applicable in clinical practice.Only molecular tests which allow a di-chotomous result are helpful in clinical decision-making in contrast to an intermediate risk classification which does not provide further information and only leads to uncertainty for patients and therapists. Global mo-lecular test methods will gain in importance in the future with regards to identification of new predictive markers, because for many new substances it is not known for which patient subgroups they can be used with highest treatment success.