Impact of 21-Gene Recurrence Score on Chemotherapy Decision in Invasive Ductal Carcinoma of Breast with Nodal Micrometastases
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose The purpose of this study was to investigate the effect of 21-gene recurrence score (RS) on predicting prognosis and chemotherapy decision in node micrometastases (N1mi) breast invasive ductal carcinoma (IDC). Materials and Methods Patients with stage T1-2N1mi and estrogen receptor-positive IDC diagnosed between 2004 and 2015 were included. The associations of 21-gene RS with breast cancer-specific survival (BCSS), chemotherapy decision, and benefit of chemotherapy were analyzed. Results We identified 4,758 patients including 1,403 patients (29.5%) treated with adjuvant chemotherapy. In the traditional RS cutoffs, 2,831 (59.5%), 1,634 (34.3%), and 293 (6.2%) patients were in the low-, intermediate-, and high-risk RS groups, respectively. In 3,853 patients with human epidermal growth factor receptor-2 (HER2) status available, most patients were HER2-negative disease (98.3%). A higher RS was independently related to chemotherapy receipt, and 14.0%, 47.7%, and 77.8% of patients in the low-, intermediate-, and high-risk RS groups received chemotherapy, respectively. The multivariate analysis indicated that a higher RS was related to worse BCSS (p < 0.001). The 5-year BCSS rates were 99.3%, 97.4%, and 91.9% in patients with low-, intermediate-, and high-risk RS groups, respectively (p < 0.001). However, chemotherapy receipt did not correlate with better BCSS in low-, intermediate-, or high-risk RS groups. There were similar trends using Trial Assigning Individualized Options for Treatment RS cutoffs. Conclusion The 21-gene RS does predict outcome and impact on chemotherapy decision of N1mi breast IDC. Large cohort and long-term outcomes studies are needed to identify the effects of chemotherapy in N1mi patients by different 21-gene RS groups.
Abstract
Purpose The purpose of this study was to investigate the effect of 21-gene recurrence score (RS) on predicting prognosis and chemotherapy decision in node micrometastases (N1mi) breast invasive ductal carcinoma (IDC). Materials and Methods Patients with stage T1-2N1mi and estrogen receptor-positive IDC diagnosed between 2004 and 2015 were included. The associations of 21-gene RS with breast cancer-specific survival (BCSS), chemotherapy decision, and benefit of chemotherapy were analyzed. Results We identified 4,758 patients including 1,403 patients (29.5%) treated with adjuvant chemotherapy. In the traditional RS cutoffs, 2,831 (59.5%), 1,634 (34.3%), and 293 (6.2%) patients were in the low-, intermediate-, and high-risk RS groups, respectively. In 3,853 patients with human epidermal growth factor receptor-2 (HER2) status available, most patients were HER2-negative disease (98.3%). A higher RS was independently related to chemotherapy receipt, and 14.0%, 47.7%, and 77.8% of patients in the low-, intermediate-, and high-risk RS groups received chemotherapy, respectively. The multivariate analysis indicated that a higher RS was related to worse BCSS (p < 0.001). The 5-year BCSS rates were 99.3%, 97.4%, and 91.9% in patients with low-, intermediate-, and high-risk RS groups, respectively (p < 0.001). However, chemotherapy receipt did not correlate with better BCSS in low-, intermediate-, or high-risk RS groups. There were similar trends using Trial Assigning Individualized Options for Treatment RS cutoffs. Conclusion The 21-gene RS does predict outcome and impact on chemotherapy decision of N1mi breast IDC. Large cohort and long-term outcomes studies are needed to identify the effects of chemotherapy in N1mi patients by different 21-gene RS groups.
참고문헌 (30)
- Maaskant AJ, "Stage migration due to introduction of the sentinel node procedure : a population-based study", Breast Cancer Res Treat, 113, pp.173~179 (2009)
- van der Heiden-van der Loo M, "Introduction of sentinel node biopsy and stage migration of breast cancer", Eur J Surg Oncol, 32, pp.710~714 (2006)
- Salhab M, "Sentinel lymph node micrometastasis in human breast cancer: an update", Surg Oncol, 20, pp.e195~e206 (2011)
- Peethambaram PP, "Use of 21-gene recurrence score assay to individualize adjuvant chemotherapy recommendations in ER+", HER2– node positive breast cancer-A National Cancer Database study, 2017, pp.3, 41~
- Montagna E, "Minimal axillary lymph node involvement in breast cancer has different prognostic implications according to the staging procedure", Breast Cancer Res Treat, 118, pp.385~394 (2009)
- Hansen NM, "Impact of micrometastases in the sentinel node of patients with invasive breast cancer", J Clin Oncol, 27, pp.4679~4684 (2009)
- Langer I, "Axillary recurrence rate in breast cancer patients with negative sentinel lymph node(SLN)or SLN micrometastases : prospective analysis of 150 patients after SLN biopsy", Ann Surg, 241, pp.152~158 (2005)
- "NCCN clinical Practice guidelines in oncology V.2.2018. Breast Cancer, Plymouth Meeting" (2018)[URL]
- Andersson Y, "Long-term breast cancer survival in relation to the metastatic tumor burden in axillary lymph nodes", Breast Cancer Res Treat, 171, pp.359~369 (2018)
- Iqbal J, "The impact of nodal micrometastasis on mortality among women with early-stage breast cancer", Breast Cancer Res Treat, 161, pp.103~115 (2017)
- De Abreu FB, "Personalized therapy for breast cancer", Clin Genet, 86, pp.62~67 (2014)
- Sabatier R, "Personalized medicine : present and future of breast cancer management", Crit Rev Oncol Hematol, 91, pp.223~233 (2014)
- Paik S, "Gene expression and benefit of chemotherapy in women with nodenegative, estrogen receptor-positive breast cancer", J Clin Oncol, 24, pp.3726~3734 (2006)
- Albain KS, "Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy : a retrospective analysis of a randomised trial", Lancet Oncol, 11, pp.55~65 (2010)
- Frazier TG, "A retrospective study of the impact of 21-gene recurrence score assay on treatment choice in node positive micrometastatic breast cancer", Pharmaceuticals(Basel), 8, pp.107~122 (2015)
- "Surveillance, Epidemiology, and End Results (SEER) Program. Oncotype DX database (2004-2015)" (2018)[URL]
- Wong WB, "The value of comparative effectiveness research : projected return on investment of the RxPONDER trial(SWOG S1007)", Contemp Clin Trials, 33, pp.1117~1123 (2012)
- Sparano JA, "Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer", N Engl J Med, 379, pp.111~121 (2018)
- Wu SP, "Post-mastectomy radiation therapy in breast cancer patients with nodal micrometastases", Ann Surg Oncol, 25, pp.2620~2631 (2018)
- Turashvili G, "21-Gene recurrence score and locoregional recurrence in lymph node-negative, estrogen receptor-positive breast cancer", Breast Cancer Res Treat, 166, pp.69~76 (2017)
- Goodman CR, "21-Gene recurrence score assay predicts benefit of post-mastectomy radiotherapy in T1-2 N1 breast cancer", Clin Cancer Res, 24, pp.3878~3887 (2018)
- Forissier V, "Is post-mastectomy radiation therapy contributive in pN0-1mi breast cancer patients? Results of a French multi-centric cohort", Eur J Cancer, 87, pp.47~57 (2017)
- de Boer M, "Micrometastases or isolated tumor cells and the outcome of breast cancer", N Engl J Med, 361, pp.653~663 (2009)
- Stemmer SM, "Clinical outcomes in ER+ HER2-node-positive breast cancer patients who were treated according to the Recurrence Score results : evidence from a large prospectively designed registry", NPJ Breast Cancer, 3, pp.32~ (2017)
- Henry NL, "Role of patient and disease factors in adjuvant systemic therapy decision making for earlystage, operable breast cancer : American Society of Clinical Oncology Endorsement of Cancer Care Ontario Guideline Recommendations", J Clin Oncol, 34, pp.2303~2311 (2016)
- D'Arcy M, "Race-associated biological differences among Luminal A breast tumors", Breast Cancer Res Treat, 152, pp.437~448 (2015)
- Giordano SH, "Decline in the use of anthracyclines for breast cancer", J Clin Oncol, 30, pp.2232~2239 (2012)
- Sparano JA, "Prospective validation of a 21-gene expression assay in breast cancer", N Engl J Med, 373, pp.2005~2014 (2015)
- Krop I, "Use of biomarkers to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer : American Society of Clinical Oncology Clinical Practice Guideline Focused Update", J Clin Oncol, 35, pp.2838~2847 (2017)
- Noone AM, "Comparison of SEER treatment data with medicare claims", Med Care, 54, pp.e55~e64 (2016)