Prognostic ability of EndoPredict compared to research-based versions of the PAM50 risk of recurrence (ROR) scores in node-positive, estrogen receptor-positive, and HER2-negative breast cancer. A GEICAM/9906 sub-study


Por: Martin M, Brase JC, Ruiz A, Prat A, Kronenwett R, Calvo L, Petry C, Bernard PS, Ruiz-Borrego M, Weber KE, Rodriguez CA, Alvarez IM, Segui MA, Perou CM, Casas M, Carrasco E, Caballero R and Rodriguez-Lescure A

Publicada: 1 feb 2016
Resumen:
There are several prognostic multigene-based tests for managing breast cancer (BC), but limited data comparing them in the same cohort. We compared the prognostic performance of the EndoPredict (EP) test (standardized for pathology laboratory) with the research-based PAM50 non-standardized qRT-PCR assay in node-positive estrogen receptor-positive (ER+) and HER2-negative (HER2-) BC patients receiving adjuvant chemotherapy followed by endocrine therapy (ET) in the GEICAM/9906 trial. EP and PAM50 risk of recurrence (ROR) scores [based on subtype (ROR-S) and on subtype and proliferation (ROR-P)] were compared in 536 ER+/HER2- patients. Scores combined with clinical information were evaluated: ROR-T (ROR-S, tumor size), ROR-PT (ROR-P, tumor size), and EPclin (EP, tumor size, nodal status). Patients were assigned to risk-categories according to prespecified cutoffs. Distant metastasis-free survival (MFS) was analyzed by Kaplan-Meier. ROR-S, ROR-P, and EP scores identified a low-risk group with a relative better outcome (10-year MFS: ROR-S 87 %; ROR-P 89 %; EP 93 %). There was no significant difference between tests. Predictors including clinical information showed superior prognostic performance compared to molecular scores alone (10-year MFS, low-risk group: ROR-T 88 %; ROR-PT 92 %; EPclin 100 %). The EPclin-based risk stratification achieved a significantly improved prediction of MFS compared to ROR-T, but not ROR-PT. All signatures added prognostic information to common clinical parameters. EPclin provided independent prognostic information beyond ROR-T and ROR-PT. ROR and EP can reliably predict risk of distant metastasis in node-positive ER+/HER2- BC patients treated with chemotherapy and ET. Addition of clinical parameters into risk scores improves their prognostic ability.

Filiaciones:
Martin M:
 Department of Medical Oncology, Instituto de Investigacion Sanitaria Gregorio Maranon, Universidad Complutente de Madrid, Calle Maiquez 7, Madrid, Spain.

Brase JC:
 Sividon Diagnostics GmbH, Cologne, Germany

Ruiz A:
 Department of Medical Oncology, Valencian Institute of Oncology (IVO), Valencia, Spain

Prat A:
 Translational Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain

Kronenwett R:
 Sividon Diagnostics GmbH, Cologne, Germany

Calvo L:
 Department of Medical Oncology, A Coruna University Hospital Complex, A Coruna, Spain

Petry C:
 Sividon Diagnostics GmbH, Cologne, Germany

Bernard PS:
 Solid Tumor Molecular Diagnostics Laboratory, ARUP Laboratories, Utah, USA

Ruiz-Borrego M:
 Department of Medical Oncology, Virgen del Rocio University Hospital, Seville, Spain

Weber KE:
 Sividon Diagnostics GmbH, Cologne, Germany

Rodriguez CA:
 Department of Medical Oncology, Salamanca University Hospital-IBSAL, Salamanca, Spain

Alvarez IM:
 Department of Medical Oncology, Donostia University Hospital, Donostia, Spain

Segui MA:
 Department of Medical Oncology, Parc Tauli University Hospital, Sabadell, Spain

Perou CM:
 Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA

 Department of Genetics, University of North Carolina, Chapel Hill, NC, USA

 Department of Pathology & Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA

Casas M:
 Spanish Breast Cancer Research Group (GEICAM), Madrid, Spain

Carrasco E:
 Spanish Breast Cancer Research Group (GEICAM), Madrid, Spain

Caballero R:
 Spanish Breast Cancer Research Group (GEICAM), Madrid, Spain

:
 Department of Medical Oncology, Elche University General Hospital, Elche, Spain
ISSN: 01676806





BREAST CANCER RESEARCH AND TREATMENT
Editorial
Springer Netherlands, Netherlands, Estados Unidos America
Tipo de documento: Article
Volumen: 156 Número: 1
Páginas: 81-89
WOS Id: 000372258800009
ID de PubMed: 26909792

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