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
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