Decision of adjuvant chemotherapy in intermediate risk luminal breast cancer patients: A prospective multicenter trial assessing the clinical and psychological impact of EndoPredict® (EpClin) use (UCBG 2–14)

e12007 Background: Breast cancer prognosis is influenced by several factors including Ki67 expression which may have a predictive role in luminal breast cancer patients. The aim of this study was to assess the value of Ki67 in breast cancers with positive hormonal receptors and HER2 overexpressed and to evaluate its impact on survival. Methods: Seventy eight consecutive patients diagnosed with locally advanced HER2 positive breast cancer who were treated with adjuvant therapy based on HER2 treatment were selected for this study (2004-2014). The adjuvant chemotherapy schemes were 44% TCH, 16% FEC, 11% AC/T and 29% other therapies. The median of followup was 68 months. Tumor proliferation was assessed immunohistochemically by Ki67 expression and calculated as percentage of stained tumor cells from this cohort previous to adjuvant chemotherapy administration and the results obtained were correlated with disease status and outcome. Results: High proliferation defined as a percentage > 15 of tumor cells was observed in 69% of the breast cancer patients cases. High proliferation significantly predicted longer overall survival (OS) (Log rank 0,012). At 10 years of follow-up, 93% of the patients with KI67 high expression were alive versus 43% of patients without overexpression. Multivariate analysis confirmed the clinical significance of Ki67 predicting OS for luminal HER2 breast cancer patients (p 0,04 y HR 9,6). Conclusions: High proliferation identifies a setting of luminal-B HER2+ subtype breast cancer patients with a significantly longer overall survival.

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EPV011/#170 Adjuvant chemotherapy-induced amenorrhea in luminal breast cancer patients: a strong prognostic factor in Tunisian premenopausal women

10.1136/ijgc-2021-igcs.78 ◽

2021 ◽

Author(s):

A Zribi ◽

I Ben Abdallah ◽

S Ben Nasr ◽

S Fendri ◽

N Mansouri ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Prognostic Factor ◽

Cancer Patients ◽

Premenopausal Women ◽

Luminal Breast Cancer ◽

Breast Cancer Patients

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The Use of Oncotype DX in Adjuvant Chemotherapy Decision-making in Early Breast Cancer Patients with Intermediate Risk of Mortality at 10 Years

Clinical Oncology ◽

10.1016/j.clon.2017.01.032 ◽

2017 ◽

Vol 29 (6) ◽

pp. e103

Author(s):

A. Ramessur ◽

C. Harper-Wyne ◽

R. Burcombe ◽

R. Jyothirmayi

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Early Breast Cancer ◽

Oncotype Dx ◽

Intermediate Risk ◽

Breast Cancer Patients ◽

Risk Of Mortality

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MINDACT: Long-term results of the large prospective trial testing the 70-gene signature MammaPrint as guidance for adjuvant chemotherapy in breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.506 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 506-506 ◽

Cited By ~ 5

Author(s):

Fatima Cardoso ◽

Laura van 't Veer ◽

Coralie Poncet ◽

Josephine Lopes Cardozo ◽

Suzette Delaloge ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Gene Signature ◽

Low Risk ◽

Phase Iii ◽

Long Term Results ◽

Luminal Breast Cancer ◽

Breast Cancer Patients

506 Background: The 70-gene signature MammaPrint has been shown to identify breast cancer patients for whom adjuvant chemotherapy (CT) could be safely omitted even in the presence of unfavorable standard clinical-pathological criteria. The MINDACT primary endpoint at 5 years median follow-up was met in 2016 (Cardoso et al, NEJM 2016) with a distant metastasis free survival (DMFS) rate at 5 years of 94.7% (95% CI: 92.5-96.2) in clinical high (C-High) / genomic low (G-Low) risk patients who received no CT. Longer follow-up is now available. Methods: 6693 patients were enrolled in the prospective phase III randomized MINDACT study (EORTC 10041/BIG3-04) between 2007-2011. We assessed the DMFS rate at 5 years in the primary test (PT) population of C-High / G-Low patients who were randomized to receive no CT (n = 644). As secondary analysis, we evaluated DMFS and overall survival (OS) in the intention to treat (ITT) population of the C-High / G-Low group randomized to CT vs no CT (n = 749 and 748 respectively). Comparisons between CT and no CT groups are low-powered. We used Kaplan-Meier estimates for time to event endpoints and hazard ratios (HR) with 95% CI from cox-regression models adjusted for stratification factors used for the randomization. Results: The median follow-up is 8.7 years, resulting in an updated 5-year DMFS rate for the PT population of C-High / G-Low patients with no CT of 95.1% (95% CI 93.1-96.6). The updated outcomes of the ITT population of C-High / G-Low patients are shown in the table. Further analyses will update the suggested age-dependent effect of CT omission for luminal breast cancer seen at 5 years in pre- versus post-menopausal women as in Tailor-X (Piccart et al, SABCS 2019). Conclusions: The primary DMFS endpoint at 5 years continues to be met in CT untreated C-High / G-Low risk women, confirming MINDACT as a positive de-escalation study. With longer follow-up and in line with the natural history of luminal breast cancer, more distant relapses do occur but the estimated gain of 2.6% for CT administration in C-High / G-Low patients remains small in light of CT harmful effects. The level IA evidence for the clinical utility of the 70-gene signature for adjuvant CT decision making is maintained. Clinical trial information: NCT00433589 . [Table: see text]

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