Prediction of late distant recurrence in patients with oestrogen-receptor-positive breast cancer: a prospective comparison of the breast-cancer index (BCI) assay, 21-gene recurrence score, and IHC4 in the TransATAC study population
Dennis C. Sgroi,Ivana Sestak,Jack Cuzick,Yi Zhang,Catherine A. Schnabel,Brock Schroeder,Mark G. Erlander,Anita K. Dunbier,Anita K. Dunbier,Kally Sidhu,Elena Lopez-Knowles,Paul E. Goss,Mitch Dowsett +12 more
TLDR
This prospective comparison study compared the prognostic ability of the breast-cancer index (BCI) assay, 21-gene recurrence score (Oncotype DX), and an immunohistochemical prognostic model (IHC4) for both early and late recurrence in patients with oestrogen-receptor-positive, node-negative breast cancer who took part in the Arimidex, Tamoxifen, Alone or in Combination clinical trial.Abstract:
Summary Background Biomarkers to improve the risk–benefit of extended adjuvant endocrine therapy for late recurrence in patients with oestrogen-receptor-positive breast cancer would be clinically valuable. We compared the prognostic ability of the breast-cancer index (BCI) assay, 21-gene recurrence score (Oncotype DX), and an immunohistochemical prognostic model (IHC4) for both early and late recurrence in patients with oestrogen-receptor-positive, node-negative (N0) disease who took part in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) clinical trial. Methods In this prospective comparison study, we obtained archival tumour blocks from the TransATAC tissue bank from all postmenopausal patients with oestrogen-receptor-positive breast cancer from whom the 21-gene recurrence score and IHC4 values had already been derived. We did BCI analysis in matched samples with sufficient residual RNA using two BCI models—cubic (BCI-C) and linear (BCI-L)—using previously validated cutoffs. We assessed prognostic ability of BCI for distant recurrence over 10 years (the primary endpoint) and compared it with that of the 21-gene recurrence score and IHC4. We also tested the ability of the assays to predict early (0–5 years) and late (5–10 years) distant recurrence. To assess the ability of the biomarkers to predict recurrence beyond standard clinicopathological variables, we calculated the change in the likelihood-ratio χ 2 (LR-Δχ 2 ) from Cox proportional hazards models. Findings Suitable tissue was available from 665 patients with oestrogen-receptor-positive, N0 breast cancer for BCI analysis. The primary analysis showed significant differences in risk of distant recurrence over 10 years in the categorical BCI-C risk groups (p 2 =22·69; p 2 =13·68; p=0·0002) and IHC4 was similar (HR 1·69 [95% CI 1·51–2·56]; LR-Δχ 2 =22·83; p 2 =15·42, p 2 =18·48, p 2 =29·14, p 2 =7·97, p=0·0048; 21-gene recurrence score HR 1·13 [0·82–1·56], LR-Δχ 2 =0·48, p=0·47; IHC4 HR 1·30 [0·88–1·94], LR-Δχ 2 =1·59, p=0·20). Interpretation BCI-L was the only significant prognostic test for risk of both early and late distant recurrence and identified two risk populations for each timeframe. It could help to identify patients at high risk for late distant recurrence who might benefit from extended endocrine or other therapy. Funding Avon Foundation, National Institutes of Health, Breast Cancer Foundation, US Department of Defense Breast Cancer Research Program, Susan G Komen for the Cure, Breakthrough Breast Cancer through the Mary-Jean Mitchell Green Foundation, AstraZeneca, Cancer Research UK, and the National Institute for Health Research Biomedical Research Centre at the Royal Marsden (London, UK).read more
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Richard Buus,Richard Buus,Belinda Yeo,Adam R. Brentnall,Marie Klintman,Maggie C.U. Cheang,Komel Khabra,Ivana Sestak,Qiong Gao,Jack Cuzick,Mitch Dowsett,Mitch Dowsett +11 more
TL;DR: The hypothesis that early and late prognostic signatures are significantly more informative than a single signature was rejected and the derived 10-year signature predicts risk of metastasis in patients with ER+/HER2− breast cancer similar to commercial signatures.
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Prognostic immune-related gene models for breast cancer: a pooled analysis.
Jianli Zhao,Ying Wang,Zengding Lao,Siting Liang,Jingyi Hou,Yunfang Yu,Herui Yao,Na You,Kai Chen +8 more
TL;DR: Immune-related gene models performed better in estrogen receptor-negative (ER−) and lymph node-positive (LN+) breast cancer subtypes and were positively correlated with ER status when evaluated using univariate analyses in most of the models under investigation.
Journal ArticleDOI
Selecting Patients for Oncotype DX Testing Using Standard Clinicopathologic Information.
Susan J. Robertson,Greg Pond,John Hilton,John Hilton,Stephanie Petkiewicz,Yasmin Ayroud,Zuzana Kos,Denis H. Gravel,Carol Stober,Lisa Vandermeer,Angel Arnaout,Angel Arnaout,Mark Clemons,Mark Clemons +13 more
TL;DR: Use of all formulae, and the Magee 3 equation in particular, are proposed as possible screening tools for ODx testing, resulting in significantly reduced frequency of ODX testing.
Journal ArticleDOI
Cancer du sein luminal et apport des classifications intrinsèques moléculaires : comment identifier les tumeurs luminales A et B en 2015 ?
TL;DR: De multiples travaux ont montre que, si environ la moitie de ces tumeurs sont associees a un tres bon pronostic, les cancers luminaux sont au cœur des enjeux de the desescalade therapeutique entamee ces dernieres annees.
Journal ArticleDOI
The ability of PAM50 risk of recurrence score to predict 10-year distant recurrence in hormone receptor-positive postmenopausal women with special histological subtypes
Anne Vibeke Lænkholm,Maj-Britt Jensen,Jens Ole Eriksen,Wesley Buckingham,Sean Ferree,Torsten O. Nielsen,Bent Ejlertsen +6 more
TL;DR: It is demonstrated that Prosigna-PAM50 continuous ROR score added significant prognostic information for 10-year DR in postmenopausal patients with special subtypes and ER-positive, HER2-normal early breast cancer.
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TL;DR: The 10-year and 15-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival are reported and it is found that the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis.
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TL;DR: The recurrence score has been validated as quantifying the likelihood of distant recurrence in tamoxifen-treated patients with node-negative, estrogen-receptor-positive breast cancer and could be used as a continuous function to predict distant recurrent in individual patients.
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Gene-expression profiles to predict distant metastasis of lymph-node-negative primary breast cancer.
Yixin Wang,Jan Klijn,Yi Zhang,Anieta M. Sieuwerts,Maxime P. Look,Fei Yang,Dmitri Talantov,Mieke Timmermans,Marion E. Meijer-van Gelder,Jack X. Yu,Tim Jatkoe,Els M.J.J. Berns,David Atkins,John A. Foekens +13 more
TL;DR: The ability to identify patients who have a favourable prognosis could, after independent confirmation, allow clinicians to avoid adjuvant systemic therapy or to choose less aggressive therapeutic options.
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