Gene expression profiling

The unpredictability in outcome in patients with very similar prognostic and predictive markers and the variability in the expression of predictive markers determined by immunohistochemistry has suggested a need for alternative approaches to define patients who will benefit from therapy. Furthermore, the definition of a specific receptor or pathway may be too narrow. Hence, much emphasis has been placed on defining gene patterns that correlate with outcomes. Gene array assessment may include DNA microarrays. DNA array are best performed on fresh frozen tissue, however newer techniques have now allowed the use paraffin-embedded tissues. Furthermore, real-time reverse-transcriptase polymerase chain reaction (RT-PCR) methods may be used to confirm expression of select genes or assessing a preselect limited number of genes.

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