Ki67 index and its association with Oncotype Dx® recurrence score in Latin-American early-breast cancer patients

e12014 Background: Oncotype-DX Assay is a 21-gene based recurrence score (RS) that helps stratify breast cancer patients based on their risk of recurrence. It is often used to help identify patients that may benefit from adjuvant chemotherapy (AC). Prior to the TAILORx Trial results, there were no guidelines for AC in patients with an intermediate score (18-30). Management of these patients was often at the clinical judgement of the provider. We sought to determine predictors of AC among these patients, and measure treatment effect on survival. Methods: We queried the Surveillance, Epidemiology, and End-Results database for breast cancer patients newly diagnosed between 2010-2015. We included patients with T1-T3, hormone receptor positive, HER2-negative, and lymph node-negative breast cancer with an intermediate RS. Male patients, those younger than 40 years, tumors 5 mm or less, and incomplete records were excluded. Univariate and multivariate analysis was performed to derive independent predictors of AC. Cox Proportional-Hazards Model was done to examine the effect of AC on survival. Results: We included 14,710 patients of whom 4,508 (30.6%) received AC. Patients that received AC were younger (55.4 years [8.8] vs 60.0 [9.7], p < 0.001), grade III or higher (29.8% vs 16.4%, p < 0.001), and had a higher RS (23.9 [3.6] vs 21.5 [3.1], p < 0.001). Higher T stage was associated with a higher rate of patients receiving AC (p < 0.001). Marital status was also associated with AC; a higher proportion of patients who received AC were married (67.9% vs 64.4%, p < 0.001). There was no significant association between race/ethnicity or insurance type with AC. Multivariate analysis showed that RS (OR: 1.24 [1.23-1.26], p < 0.001), T stage (OR: 1.67 [1.21-2.30], p < 0.001), and a grade III tumor (OR: 1.85 [1.64-2.09], p < 0.001) were the strongest predictors of AC. The age decile 80-89 years (OR: 0.05 [0.02-0.10], p < 0.001) was the most negative predictor of AC. AC did not have an effect on 5 year overall survival (97.6% vs 96.0%, p = 0.28). Conclusions: Between 2010-2015, our study shows 30.6% of breast cancers patients with an intermediate Oncotype-DX score were given AC. The decision to treat was largely based on tumor size, grade and age. AC had no effect on overall survival.

Download Full-text

Oncotype-DX recurrence score distribution in breast cancer patients with BRCA1/2 mutations

Breast Cancer Research and Treatment ◽

10.1007/s10549-016-3836-6 ◽

2016 ◽

Vol 157 (3) ◽

pp. 511-516 ◽

Cited By ~ 12

Author(s):

R. Lewin ◽

A. Sulkes ◽

T. Shochat ◽

D. Tsoref ◽

S. Rizel ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Recurrence Score ◽

Oncotype Dx ◽

Breast Cancer Patients ◽

Score Distribution ◽

Oncotype Dx Recurrence Score

Download Full-text

Abstract P1-06-06: No age-related outcome disparities according to 21-gene recurrence score groups in early breast cancer patients treated by adjuvant chemotherapy in the prospective WSG PlanB trial

10.1158/1538-7445.sabcs17-p1-06-06 ◽

2018 ◽

Cited By ~ 1

Author(s):

N Harbeck ◽

O Gluz ◽

R Wuerstlein ◽

M Clemens ◽

W Malter ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Early Breast Cancer ◽

Recurrence Score ◽

Breast Cancer Patients ◽

Age Related

Download Full-text

Germline variants associated with leukocyte genes predict tumor recurrence in breast cancer patients

npj Precision Oncology ◽

10.1038/s41698-019-0100-7 ◽

2019 ◽

Vol 3 (1) ◽

Cited By ~ 9

Author(s):

Jean-Sébastien Milanese ◽

Chabane Tibiche ◽

Jinfeng Zou ◽

Zhigang Meng ◽

Andre Nantel ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Clinical Outcomes ◽

Cell Function ◽

Recurrence Score ◽

Oncotype Dx ◽

Breast Cancer Patients ◽

Sequencing Data ◽

Germline Variants ◽

Gene Signatures

Abstract Germline variants such as BRCA1/2 play an important role in tumorigenesis and clinical outcomes of cancer patients. However, only a small fraction (i.e., 5–10%) of inherited variants has been associated with clinical outcomes (e.g., BRCA1/2, APC, TP53, PTEN and so on). The challenge remains in using these inherited germline variants to predict clinical outcomes of cancer patient population. In an attempt to solve this issue, we applied our recently developed algorithm, eTumorMetastasis, which constructs predictive models, on exome sequencing data to ER+ breast (n = 755) cancer patients. Gene signatures derived from the genes containing functionally germline variants significantly distinguished recurred and non-recurred patients in two ER+ breast cancer independent cohorts (n = 200 and 295, P = 1.4 × 10−3). Furthermore, we compared our results with the widely known Oncotype DX test (i.e., Oncotype DX breast cancer recurrence score) and outperformed prediction for both high- and low-risk groups. Finally, we found that recurred patients possessed a higher rate of germline variants. In addition, the inherited germline variants from these gene signatures were predominately enriched in T cell function, antigen presentation, and cytokine interactions, likely impairing the adaptive and innate immune response thus favoring a pro-tumorigenic environment. Hence, germline genomic information could be used for developing non-invasive genomic tests for predicting patients’ outcomes in breast cancer.

Download Full-text

Impact of Oncotype DX testing on ER+ breast cancer treatment and survival in the first decade of use

Breast Cancer Research ◽

10.1186/s13058-021-01453-4 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Evelien Schaafsma ◽

Baoyi Zhang ◽

Merit Schaafsma ◽

Chun-Yip Tong ◽

Lanjing Zhang ◽

...

Keyword(s):

Breast Cancer ◽

High Risk ◽

Cancer Patients ◽

Temporal Trends ◽

Recurrence Score ◽

Low Risk ◽

Oncotype Dx ◽

Risk Scores ◽

Breast Cancer Patients ◽

Risk Patients

Abstract Background The Oncotype DX breast recurrence score has been introduced more than a decade ago to aid physicians in determining the need for systemic adjuvant chemotherapy in patients with early-stage, estrogen receptor (ER)+, lymph node-negative breast cancer. Methods In this study, we utilized data from The Surveillance, Epidemiology, and End Results (SEER) Program to investigate temporal trends in Oncotype DX usage among US breast cancer patients in the first decade after the introduction of the Oncotype DX assay. Results We found that the use of Oncotype DX has steadily increased in the first decade of use and that this increase is associated with a decreased usage of chemotherapy. Patients who utilized the Oncotype DX test tended to have improved survival compared to patients who did not use the assay even after adjusting for clinical variables associated with prognosis. In addition, chemotherapy usage in patients with high-risk scores is associated with significantly longer overall and breast cancer-specific survival compared to high-risk patients who did not receive chemotherapy. On the contrary, patients with low-risk scores who were treated with chemotherapy tended to have shorter overall survival compared to low-risk patients who forwent chemotherapy. Conclusion We have provided a comprehensive temporal overview of the use of Oncotype DX in breast cancer patients in the first decade after Oncotype DX was introduced. Our results suggest that the use of Oncotype DX is increasing in ER+ breast cancer and that the Oncotype DX test results provide valuable information for patient treatment and prognosis.

Download Full-text

MRI-Based Radiomics Approach Predicts Tumor Recurrence in ER+/HER2- Early Breast Cancer Patients

10.21203/rs.3.rs-1134410/v1 ◽

2021 ◽

Author(s):

Andrea Delli Pizzi ◽

Domenico Mastrodicasa ◽

Antonio Maria Chiarelli ◽

Piero Chiacchiaretta ◽

Riccardo Luberti ◽

...

Keyword(s):

Breast Cancer ◽

Early Breast Cancer ◽

Tumor Recurrence ◽

Learning Algorithm ◽

Recurrence Score ◽

Partial Least Square ◽

Least Square ◽

Oncotype Dx ◽

Breast Cancer Patients ◽

Risk Of Cancer

Abstract Oncotype Dx is a genetic assay providing a recurrence score (RS) correlated with the risk of cancer recurrence and adjuvant treatment response in breast carcinoma. We investigated the ability of an MRI-based radiomics approach to predict the risk of tumor recurrence in breast cancer. A total of 62 patients with biopsy-proved ER+/HER2- early breast cancer who underwent pre-treatment MRI and Oncotype Dx were included. An RS>25 was considered discriminant between low-intermediate and high risk of tumor recurrence. Two readers segmented each tumor. Radiomics features were extracted from the tumor and the peritumoral tissues. Partial least square (PLS) regression was used as the multivariate machine-learning algorithm. PLS β-weights of radiomics features included the 5% features with the largest β-weights in magnitude (top 5%). The diagnostic performance of the radiomics model was assessed through receiver operating characteristic (ROC) analysis. A null hypothesis probability threshold of 5% was chosen (p < 0.05). The predictive model delivered an AUC of 0.76. Of the 47 features included in the top 5%, 33 were texture-related and derived from the tumor and the peritumoral tissues. After a prospective evaluation in more extensive clinical trials, this approach may identify non-invasively patients who are more likely to benefit from adjuvant therapy.

Download Full-text