70-Gene signature-guided adjuvant systemic treatment adjustments in early-stage ER plus breast cancer patients: 7-year follow-up of a prospective multicenter cohort study

被引：0

作者：

Verreck, Eline E. F. ^{[1
,2
,22
]}

Kuijer, Anne ^{[3
]}

van Steenhoven, Julia E. C. ^{[2
,4
]}

Volders, Jose H. ^{[2
]}

van der Velden, Annette W. G. ^{[5
]}

Siesling, Sabine ^{[6
,7
]}

Timmer-Bonte, Anja N. H. ^{[8
]}

Smilde, Tineke J. ^{[9
]}

Imholz, Alex L. T. ^{[10
]}

Blanken-Peeters, Charlotte F. J. M. ^{[11
]}

de Valk, Bart ^{[12
]}

Vrijaldenhoven, Suzan ^{[13
]}

Lastdrager, Willem B. ^{[14
]}

Haringhuizen, Annebeth W. ^{[15
]}

Hunting, Jarmo C. B. ^{[16
]}

Hovenga, Sjoerd ^{[17
]}

Nieboer, Peter ^{[18
]}

Zuetenhorst, Hanneke M. ^{[19
]}

Tetteroo, Geert W. M. ^{[20
]}

Smorenburg, Carolien H. ^{[21
]}

van Maaren, Marissa C. ^{[6
,7
]}

van Dalen, Thijs ^{[22
,23
]}

机构：

[1] Univ Utrecht, Utrecht, Netherlands

[2] Dept Surg, Diakonessenhuis, BOSBOOMSTR 1, NL-3582 KE UTRECHT, Netherlands

[3] St Antonius Hosp, Dept Surg, Nieuwegein, Netherlands

[4] Univ Med Ctr Utrecht, Dept Pathol, Utrecht, Netherlands

[5] Martini Hosp, Dept Internal Med, Groningen, Netherlands

[6] Univ Twente, Tech Med Ctr, Dept Hlth Technol & Serv Res, Enschede, Netherlands

[7] Netherlands Comprehens Canc Org IKNL, Dept Res & Dev, Utrecht, Netherlands

[8] Alexander Monro Hosp, Dept Internal Med, Bilthoven, Netherlands

[9] Jeroen Bosch Hosp, Dept Internal Med, Den Bosch, Netherlands

[10] Deventer Hosp, Dept Internal Med, Deventer, Netherlands

[11] Rijnstate Hosp Arnhem, Dept Surg, Arnhem, Netherlands

[12] Spaarne Gasthuis, Dept Internal Med, Hoofddorp, Netherlands

[13] Noordwest Ziekenhuisgroep, Dept Internal Med, Alkmaar, Netherlands

[14] Gelre Hosp, Dept Surg, Apeldoorn, Netherlands

[15] Gelderse Vallei Hosp, Deparmtent Internal Med, Ede, Netherlands

[16] St Antonius Hosp, Dept Internal Med, Nieuwegein, Netherlands

[17] NIJ SMELLINGHE HOSP, Dept Internal Med, DRACHTEN, Netherlands

[18] Wilhemina Hosp, Deparment Internal Med, Assen, Netherlands

[19] Franciscus Gasthuis, Dept Internal Med, Rotterdam, Netherlands

[20] Ijsselland Hosp, Dept Surg, Cappele, Netherlands

[21] Antoni Leeuwenhoek Hosp, Dept Internal Med, Amsterdam, Netherlands

[22] Erasmus MC, Dept Surg, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

[23] Univ Med Ctr Utrecht, Dept Surg, Utrecht, Netherlands

来源：

BREAST CANCER RESEARCH AND TREATMENT | 2025年 / 209卷 / 02期

关键词：

70-Gene Signature; Chemotherapy decision; Luminal breast cancer; TREATMENT DECISIONS; CHEMOTHERAPY; NETHERLANDS; TAMOXIFEN; AID;

D O I：

10.1007/s10549-024-07496-3

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundA previous prospective multicenter study revealed the change of the oncologists' chemotherapy advice due to the 70-Gene signature (GS) test result in half of the estrogen receptor-positive (ER+) invasive early-stage breast cancer patients with disputable chemotherapy indication. This resulted in less patients receiving chemotherapy. This study aims to complement these results by the 7-year oncological outcomes according to the 70-GS test result and the oncologists' pre-test advice.MethodsPatients operated for early-stage ER+ breast cancer with disputable chemotherapy indication, had been prospectively included between 2013 and 2015. Oncologists were asked whether they intended to administer adjuvant chemotherapy before deployment of the 70-GS test. Information on adjuvant systemic treatment and oncological outcome was obtained through active follow-up by data managers of the Netherlands Cancer Registry. The primary endpoint of this study was distant metastasis-free survival (DMFS) according to the genomic risk. Exploratory analyses were done to evaluate DMFS in relation to the oncologists' pre-test advice.ResultsAfter a median follow-up of 7 years, distant metastases were diagnosed in 23 of the 606 patients (3.8%) and 36 (5.9%) patients had died. The DMFS rate for the 357 70-GS genomic low-risk patients was 94.2% (95% CI 91.2-96.2) and 89.1% for the 249 genomic high-risk patients (95% CI 84.3-92.4). Of the low-risk patients 3% had received chemotherapy compared to 80% of the high-risk patients. For the subgroups based on the pre-test oncologists' advice (no chemotherapy/chemotherapy/unsure) there were no clinically relevant differences in DMFS (89.8, 93.2 and 92.0%, respectively), while comparable proportions of patients had received chemotherapy.ConclusionsIn patients with early-stage ER+ breast cancer with a disputable chemotherapy indication it is sensible to deploy the 70-GS to better select patients for adjuvant chemotherapy.

引用

页码：331 / 340

页数：10

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