Prognostic value of the 21-gene recurrence score in ER-positive, HER2-negative, node-positive breast cancer was similar in node-negative diseases: a single-center study of 800 patients

2020 ◽  
Author(s):  
Jiayi Wu ◽  
Weiqi Gao ◽  
Xiaosong Chen ◽  
Chunxiao Fei ◽  
Lin Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Value ◽  
Recurrence Score ◽  
Single Center ◽  
Node Negative ◽  
Node Positive ◽  
Single Center Study ◽  
Er Positive ◽  
Center Study ◽  
Positive Breast Cancer

scholarly journals 21-Gene Recurrence Score and Locoregional Recurrence in Node-Positive/ER-Positive Breast Cancer Treated With Chemo-Endocrine Therapy

2017 ◽  
Vol 109 (4) ◽  
pp. djw259 ◽  
Author(s):  
Eleftherios P. Mamounas ◽  
Qing Liu ◽  
Soonmyung Paik ◽  
Frederick L. Baehner ◽  
Gong Tang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Locoregional Recurrence ◽  
Recurrence Score ◽  
Node Positive ◽  
Er Positive ◽  
Positive Breast Cancer

Prediction of Risk of Distant Recurrence Using the 21-Gene Recurrence Score in Node-Negative and Node-Positive Postmenopausal Patients With Breast Cancer Treated With Anastrozole or Tamoxifen: A TransATAC Study

2010 ◽  
Vol 28 (11) ◽  
pp. 1829-1834 ◽  
Author(s):  
Mitch Dowsett ◽  
Jack Cuzick ◽  
Christopher Wale ◽  
John Forbes ◽  
Elizabeth A. Mallon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Prognostic Value ◽  
Recurrence Score ◽  
Distant Recurrence ◽  
Cox Proportional Hazards ◽  
Node Negative ◽  
Node Positive ◽  
Hormone Receptor Positive ◽  
Node Status

Purpose To determine whether the Recurrence Score (RS) provided independent information on risk of distant recurrence (DR) in the tamoxifen and anastrozole arms of the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trial. Patients and Methods RNA was extracted from 1,372 tumor blocks from postmenopausal patients with hormone receptor–positive primary breast cancer in the monotherapy arms of ATAC. Twenty-one genes were assessed by quantitative reverse transcriptase polymerase chain reaction, and the RS was calculated. Cox proportional hazards models assessed the value of adding RS to a model with clinical variables (age, tumor size, grade, and treatment) in node-negative (N0) and node-positive (N+) women. Results Reportable scores were available from 1,231 evaluable patients (N0, n = 872; N+, n = 306; and node status unknown, n = 53); 72, 74, and six DRs occurred in N0, N+, and node status unknown patients, respectively. For both N0 and N+ patients, RS was significantly associated with time to DR in multivariate analyses (P < .001 for N0 and P = .002 for N+). RS also showed significant prognostic value beyond that provided by Adjuvant! Online (P < .001). Nine-year DR rates in low (RS < 18), intermediate (RS = 18 to 30), and high RS (RS ≥ 31) groups were 4%, 12%, and 25%, respectively, in N0 patients and 17%, 28%, and 49%, respectively, in N+ patients. The prognostic value of RS was similar in anastrozole- and tamoxifen-treated patients. Conclusion This study confirmed the performance of RS in postmenopausal HR+ patients treated with tamoxifen in a large contemporary population and demonstrated that RS is an independent predictor of DR in N0 and N+ hormone receptor–positive patients treated with anastrozole, adding value to estimates with standard clinicopathologic features.

scholarly journals Association Between the 21-Gene Recurrence Score Assay and Risk of Locoregional Recurrence in Node-Negative, Estrogen Receptor–Positive Breast Cancer: Results From NSABP B-14 and NSABP B-20

2010 ◽  
Vol 28 (10) ◽  
pp. 1677-1683 ◽  
Author(s):  
Eleftherios P. Mamounas ◽  
Gong Tang ◽  
Bernard Fisher ◽  
Soonmyung Paik ◽  
Steven Shak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Locoregional Recurrence ◽  
Recurrence Score ◽  
Distant Recurrence ◽  
Locoregional Therapy ◽  
Second Primary ◽  
Node Negative ◽  
Er Positive ◽  
Positive Breast Cancer

Purpose The 21-gene OncotypeDX recurrence score (RS) assay quantifies the risk of distant recurrence in tamoxifen-treated patients with node-negative, estrogen receptor (ER)–positive breast cancer. We investigated the association between RS and risk for locoregional recurrence (LRR) in patients with node-negative, ER-positive breast cancer from two National Surgical Adjuvant Breast and Bowel Project (NSABP) trials (NSABP B-14 and B-20). Patients and Methods RS was available for 895 tamoxifen-treated patients (from both trials), 355 placebo-treated patients (from B-14), and 424 chemotherapy plus tamoxifen-treated patients (from B-20). The primary end point was time to first LRR. Distant metastases, second primary cancers, and deaths before LRR were censored. Results In tamoxifen-treated patients, LRR was significantly associated with RS risk groups (P < .001). The 10-year Kaplan-Meier estimate of LRR was 4.% (95% CI, 2.3% to 6.3%) for patients with a low RS (< 18), 7.2% (95% CI, 3.4% to 11.0%) for those with intermediate RS (18-30), and 15.8% (95% CI, 10.4% to 21.2%) for those with a high RS (> 30). There were also significant associations between RS and LRR in placebo-treated patients from B-14 (P = .022) and in chemotherapy plus tamoxifen–treated patients from B-20 (P = .028). In multivariate analysis, RS was an independent significant predictor of LRR along with age and type of initial treatment. Conclusion Similar to the association between RS and risk for distant recurrence, a significant association exists between RS and risk for LRR. This information has biologic consequences and potential clinical implications relative to locoregional therapy decisions for patients with node-negative and ER-positive breast cancer.

scholarly journals Risk of Recurrence and Chemotherapy Benefit for Patients With Node-Negative, Estrogen Receptor–Positive Breast Cancer: Recurrence Score Alone and Integrated With Pathologic and Clinical Factors

2011 ◽  
Vol 29 (33) ◽  
pp. 4365-4372 ◽  
Author(s):  
Gong Tang ◽  
Jack Cuzick ◽  
Joseph P. Costantino ◽  
Mitch Dowsett ◽  
John F. Forbes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recurrence Score ◽  
Recurrence Risk ◽  
Distant Recurrence ◽  
Risk Assessments ◽  
Intermediate Risk ◽  
Clinical Factors ◽  
Node Negative ◽  
Er Positive ◽  
Positive Breast Cancer

Purpose The 21-gene breast cancer assay recurrence score (RS) is widely used for assessing recurrence risk and predicting chemotherapy benefit in patients with estrogen receptor (ER) –positive breast cancer. Pathologic and clinical factors such as tumor size, grade, and patient age also provide independent prognostic utility. We developed a formal integration of these measures and evaluated its prognostic and predictive value. Patients and Methods From the National Surgical Adjuvant Breast and Bowel (NSABP) B-14 and translational research cohort of the Arimidex, Tamoxifen Alone or in Combination (TransATAC) studies, we included patients who received hormonal monotherapy, had ER-positive tumors, and RS and traditional clinicopathologic factors assessed (647 and 1,088, respectively). Individual patient risk assessments from separate Cox models were combined using meta-analysis to form an RS-pathology-clinical (RSPC) assessment of distant recurrence risk. Risk assessments by RS and RSPC were compared in node-negative (N0) patients. RSPC was compared with RS for predicting chemotherapy benefit in NSABP B-20. Results RSPC had significantly more prognostic value for distant recurrence than did RS (P < .001) and showed better separation of risk in the study population. RSPC classified fewer patients as intermediate risk (17.8% v 26.7%, P < .001) and more patients as lower risk (63.8% v 54.2%, P < .001) than did RS among 1,444 N0 ER-positive patients. In B-20, the interaction of RSPC with chemotherapy was not statistically significant (P = .10), in contrast to the previously reported significant interaction of RS with chemotherapy (P = .037). Conclusion RSPC refines the assessment of distant recurrence risk and reduces the number of patients classified as intermediate risk. Adding clinicopathologic measures did not seem to enhance the value of RS alone nor the individual biology RS identifies in predicting chemotherapy benefit.

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