scholarly journals The Oncotype DX recurrence score impact on the management of ER-positive, HER2-negative, node-negative breast cancer

2021 ◽  
Vol 6 (3) ◽  
pp. 211-216
Author(s):  
Abdalla Saad Abdalla Al-Zawi
Keyword(s):  
Breast Cancer ◽  
Recurrence Score ◽  
Oncotype Dx ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Er Positive ◽  
Oncotype Dx Recurrence Score

A comparative analysis of distant recurrence risk assessments by Oncotype DX recurrence score alone and integrated with clinicopathologic factors in early-stage breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 598-598 ◽  
Author(s):  
Ciara Marie Kelly ◽  
Rose Beamish ◽  
John McCaffrey ◽  
Martina SMITH ◽  
John Crown ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recurrence Score ◽  
Risk Groups ◽  
Recurrence Risk ◽  
Distant Recurrence ◽  
Oncotype Dx ◽  
Node Negative ◽  
Er Positive ◽  
Clinicopathologic Factors ◽  
Oncotype Dx Recurrence Score

598 Background: Treatment planning for patients with node negative, ER-positive, HER-2 negative breast cancer often incorporates the use of prognostic and predictive tools like Oncotype DX. Prior to the availabilty of Oncotype DX, clinicopathologic factors such as age, nodal status, tumour size and grade were used to determine risk of recurrence (ROR). RSPC represents a validated formal integration of oncotype DX recurrence score (RS) and clinicopathologic factors that further refines prognostic accuracy. RSPC does not improve the prediction of likelihood of chemotherapy benefit. The objective of this study was to compare distant recurrence risk assessment by RS and RSPC. Methods: We included patients with node negative, ER-positive, HER2-negative breast cancer who had Oncotype DX testing routinely or on clinical trial. We retrospectively reviewed patient charts and extracted clinicopathological and RS data. We calculated the RSPC using the RSPC educational tool. A comparative analysis was performed looking at the statification of patients into low (LR), intermediate (IR) and high (HR) ROR groups by RS and RSPC. The cut offs for low, intermediate and high risk by the RSPC were set to less than 12%, 12-20% and more than 20% risk of distant recurrence at 10yrs, corresponding to the risks of recurrence associated with the RS categories. Results: We identified 658 patients from 5 academic hospitals in Ireland and the US. Oncotype DX RS classified the following proportions of patients into three risk groups for distant recurrence: LR, n=334 (50.5%), IR, n=259 (39.4%), HR, n=67 (10.1%). RSPC classified the following proportion of patients into the three risk groups for recurrence: LR, n= 455 (69.1%), IR, n=110 (16.7%), HR, n=93 (14.1%). RSPC reclassified 72.6% (n=188) of the IR group (59.1% (n=153) from IR to LR and 13.5% (n=35) from IR to HR). RPSC reclassified 10.5% (n=35) of the LR group (8.1% (n=27) from LR to IR, and 2.4% (n=8) from LR to HR). RSPC reclassified 25.3% (n=17) of the HR group (17.9% (n=12) from HR to IR, and 7.4% (n=5) from HR to LR). Conclusions: RSPC reclassified 240 patients (36.5%) and was most helpful reassigning the IR group.

Does Oncotype DX recurrence score correlate with survival benefit in “good prognosis” patients as estimated by AdjuvantOnline!?

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 38-38
Author(s):  
L. C. Connell ◽  
M. Teo ◽  
S. O'Reilly ◽  
R. Beamish ◽  
E. J. Moylan
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Survival Benefit ◽  
Recurrence Score ◽  
Good Prognosis ◽  
Oncotype Dx ◽  
Absolute Difference ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Er Positive

38 Background: An important question for ER positive, node negative breast cancer is the benefit of chemotherapy over hormonal therapy. We sought to explore if a low estimate of chemotherapy benefit, based on AdjuvantOnline, correlated with low risk Oncotype DX score , identifying patients (pts) for whom the “hormone therapy alone” treatment decision would not change. Methods: Our institutional database was reviewed to identify pts with ER positive, HER2 negative, node negative breast cancer submitted for oncotype DX testing. Clinicopathologic data and Oncotype Recurrence Score (RS) were extracted and entered into ‘Adjuvantonline’ to obtain estimated survival benefit gained at 10 years (yrs) (SBG@10). Two datasets were obtained; survival benefit gained at 10 yrs from chemotherapy only (SBG@10+C) and net survival benefit gained at 10 yrs: the absolute difference between combined therapy and hormone therapy (SBG@10 net). Pts were distributed into subgroups SBG@10 ≤3% and >3%. i.e. RS ≤18 versus >18.Correlation between SBG and RS were calculated with Spearman’s Rank method. Distribution of RS were compared with Mann-Whitney and Χ2 tests. Results: We identified 77 pts. For SBG@10+C ≤3% (n=28) and >3% (n=49) subgroups, 16 (57.1%) and 23 (46.7%) had low RS, respectively (p=0.53). Three (10.7%) and 10 (20.4%) in each subgroup had high RS (p=0.48). Distribution of RS between both subgroups was not significantly different, p=0.38. Correlation between RS and SBG@10 in the ≤3% subgroup was weak (rs=0.37, p=0.05). For SBG@10 net ≤3% (n=45) and >3% (n=32) subgroups, 25 (55.6%) and 14 (43.8%) had low RS, respectively (p=0.43). Five (11.1%) and 8 (25%) in each subgroup had high RS (p=0.20). Distribution of RS between both subgroups was not significantly different, p=0.19. Correlation between RS and SGB@10 in the ≤3% subgroup was weak (rs=0.21, p=0.15). Conclusions: Although the decision for additional chemotherapy changed for ≈10% with Oncotype DX, we could not identify a cohort of good prognosis pts for whom Oncotype DX would not significantly alter treatment recommendations. There are no subsets of node negative, ER positive, breast cancer for whom Oncotype DX does not provide independently significant prognostic and predictive information.

A novel 95-gene signature (Curebest 95GC Breast) that predicts recurrence-risk in patients with ER-positive, HER2-negative, node-negative, early-stage primary invasive breast cancer with an intermediate Oncotype DX Recurrence Score.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 542-542
Author(s):  
Takeo Fujii ◽  
Hiroko Masuda ◽  
Yee Chung Cheng ◽  
Fei Yang ◽  
Aysegul A. Sahin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Recurrence Score ◽  
Recurrence Risk ◽  
Gene Signature ◽  
Oncotype Dx ◽  
Node Negative ◽  
Er Positive ◽  
Chemoendocrine Therapy ◽  
Oncotype Dx Recurrence Score

542 Background: The TAILORx trial demonstrated that adjuvant endocrine and chemoendocrine therapies had similar efficacy in patients with hormone receptor-positive, HER2-negative, node-negative breast cancer with an Oncotype DX recurrence score (RS) of 11-25. However, a predictive strategy is needed to identify patients with intermediate RS who may benefit from adjuvant chemoendocrine therapy. Curebest 95GC Breast (95GC) is a 95-gene signature that can stratify patients into two groups with high (95GC-H) and low (95GC-L) groups to predict the risk of recurrence. Our primary objective was to show that 95GC can classify patients with intermediate RS into binary recurrence risk groups. Methods: Patients with ER-positive, HER2-negative, node-negative invasive breast cancer and RS 11-30 who underwent definitive surgery and adjuvant endocrine therapy were included. RNA was derived from archived formalin-fixed, paraffin-embedded samples, and 95GC was calculated as reported previously. The Fisher exact and Brunner-Munzel tests were used to compare variables between 95GC groups. A Kaplan-Meier estimate with a log-rank test was used for recurrence-free survival (RFS) analysis. Results: The analysis included 178 patients from five institutions. The 5-year RFS rate in patients with RS 18-30 was higher in the 95GC-L group (n = 129, 96.3%) than in the 95GC-H group (n = 49, 90.9%; p = 0.002), which was consistent with results in an independent Japanese population (n = 224; p < 0.001). RFS rates significantly differed between the groups among patients with RS 11-25 as well (95GC-L, 97.4%; 95GC-H, 87.1%; p = 0.001). RFS rates did not differ between patients with RS 18-25 (94.8%) and those with RS 26-30 (93.8%; p = 0.33). Conclusions: 95GC can predict recurrence risk in patients with ER-positive, HER2-negative, node-negative invasive breast cancer and intermediate RS. Further prospective retrospective studies in the TAILORx population are warranted to confirm that 95GC can identify patients who may benefit from adjuvant chemoendocrine therapy.

scholarly journals A 95-gene Signature Stratifies Recurrence Risk of Invasive Disease in ER-positive, HER2-negative, Node-negative Breast Cancer With Intermediate 21-gene Signature Recurrence Scores

2021 ◽  
Author(s):  
Takeo Fujii ◽  
Hiroko Masuda ◽  
Yee Chung Cheng ◽  
Fei Yang ◽  
Aysegul A. Sahin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recurrence Score ◽  
Recurrence Risk ◽  
Gene Signature ◽  
Invasive Disease ◽  
Cytotoxic Agents ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Er Positive ◽  
Chemoendocrine Therapy

Abstract Purpose A subset of patients with intermediate 21-gene signature assay recurrence score may benefit from adjuvant chemoendocrine therapy, but a predictive strategy is needed to identify such patients. The 95-gene signature assay was tested to stratify patients with intermediate RS into high (95GC-H) and low (95GC-L) groups that were associated with invasive recurrence risk.Methods Patients with ER-positive, HER2-negative, node-negative breast cancer and RS 11-25 who underwent definitive surgery and adjuvant endocrine therapy without any cytotoxic agents were included. RNA was extracted from archived formalin-fixed, paraffin-embedded samples, and 95-gene signature was calculated. Results Two hundred six patients had RS of 11-25 (95GC-L, N = 163; 95GC-H, N = 43). In Cox proportional hazards model, 95GC-H was significantly associated with shorter time to recurrence than was 95GC-L (HR 5.94; 95%CI 1.81-19.53; P = 0.005). The correlation between 95-gene signature and 21-gene signature assay scores was not strong (correlation coefficient r = 0.27), which might suggest that 95-gene signature reflects biological characteristics differing from what 21-gene signature shows.Conclusions The 95-gene signature stratifies patients with ER-positive, HER2-negative, node-negative invasive breast cancer and intermediate RS of 11-25 into high and low groups that are associated with recurrence risk of invasive disease. Further retrospective analysis in the prospectively-accrued TAILORx population is warranted to confirm that 95-gene signature can identify patients who would benefit from adjuvant chemoendocrine therapy.

Comparison of PAM50 Risk of Recurrence Score With Oncotype DX and IHC4 for Predicting Risk of Distant Recurrence After Endocrine Therapy

2013 ◽  
Vol 31 (22) ◽  
pp. 2783-2790 ◽  
Author(s):  
Mitch Dowsett ◽  
Ivana Sestak ◽  
Elena Lopez-Knowles ◽  
Kalvinder Sidhu ◽  
Anita K. Dunbier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Growth Factor Receptor ◽  
Recurrence Score ◽  
Risk Groups ◽  
Distant Recurrence ◽  
Oncotype Dx ◽  
Prognostic Information ◽  
Node Negative ◽  
Risk Of Recurrence ◽  
Er Positive

Purpose Risk of distant recurrence (DR) among women with estrogen receptor (ER) –positive early breast cancer is the major determinant of recommendations for or against chemotherapy. It is frequently estimated using the Oncotype DX recurrence score (RS). The PAM50 risk of recurrence (ROR) score provides an alternative approach, which also identifies intrinsic subtypes. Patients and Methods mRNA from 1,017 patients with ER-positive primary breast cancer treated with anastrozole or tamoxifen in the ATAC trial was assessed for ROR using the NanoString nCounter. Likelihood ratio (LR) tests and concordance indices (c indices) were used to assess the prognostic information provided beyond that of a clinical treatment score (CTS) by RS, ROR, or IHC4, an index of DR risk derived from immunohistochemical assessment of ER, progesterone receptor, human epidermal growth factor receptor 2 (HER2), and Ki67. Results ROR added significant prognostic information beyond CTS in all patients (Δ LR-χ2 = 33.9; P < .001) and in all four subgroups: node negative, node positive, HER2 negative, and HER2 negative/node negative; more information was added by ROR than by RS. C indices in the HER2-negative/node-negative subgroup were 0.73, 0.76, and 0.78 for CTS, CTS plus RS, and CTS plus ROR, respectively. More patients were scored as high risk and fewer as intermediate risk by ROR than by RS. Relatively similar prognostic information was added by ROR and IHC4 in all patients but more by ROR in the HER2-negative/node-negative group. Conclusion ROR provides more prognostic information in endocrine-treated patients with ER-positive, node-negative disease than RS, with better differentiation of intermediate- and higher-risk groups.

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