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Title: 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.
Authors: Martin, Miguel
Brase, Jan C
Ruiz, Amparo
Prat, Aleix
Kronenwett, Ralf
Calvo, Lourdes
Petry, Christoph
Bernard, Philip S
Ruiz-Borrego, Manuel
Weber, Karsten E
Rodriguez, César A
Alvarez, Isabel M
Segui, Miguel A
Perou, Charles M
Casas, Maribel
Carrasco, Eva
Caballero, Rosalía
Rodriguez-Lescure, Alvaro
Keywords: Breast cancer;Chemotherapy;EndoPredict;PAM50;Prognosis
metadata.dc.subject.mesh: Antineoplastic Agents, Hormonal
Breast Neoplasms
Chemotherapy, Adjuvant
Kaplan-Meier Estimate
Receptor, ErbB-2
Receptors, Estrogen
Risk Assessment
Treatment Outcome
Issue Date: 24-Feb-2016
Abstract: 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.
metadata.dc.identifier.doi: 10.1007/s10549-016-3725-z
Appears in Collections:Producción 2020

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