A combination of Nottingham prognostic index and IHC4 score predicts pathological complete response of neoadjuvant chemotherapy in estrogen receptor positive breast cancer

被引：12
作者：
Tan, Weige [1 ,2 ,3 ]
Luo, Wei [1 ,2 ]
Jia, Weijuan [1 ,2 ]
Liang, Gehao [1 ,2 ]
Xie, Xinhua [4 ]
Zheng, Wenbo [3 ]
Song, Erwei [1 ,2 ,5 ]
Su, Fengxi [1 ,2 ]
Gong, Chang [1 ,2 ]
机构：
[1] Sun Yat Sen Univ, Guangdong Prov Key Lab Malignant Tumor Epigenet &, Guangzhou, Guangdong, Peoples R China
[2] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Breast Tumor Ctr, Guangzhou, Guangdong, Peoples R China
[3] Guangzhou Med Univ, Affiliated Hosp 1, Dept Breast Surg, Guangzhou, Guangdong, Peoples R China
[4] Sun Yat Sen Univ, Ctr Canc, State Key Lab Oncol South China, Collaborat Innovat Ctr Canc Med, Guangzhou, Guangdong, Peoples R China
[5] Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, Guangzhou, Peoples R China
来源：
ONCOTARGET | 2016年 / 7卷 / 52期
基金：
美国国家科学基金会;
关键词：
breast cancer; pathologic complete response; neoadjuvant chemotherapy; Nottingham prognostic index; IHC4; 21-GENE RECURRENCE SCORE; DECISION-MAKING; THERAPY; IMPACT; ASSAY; CYCLOPHOSPHAMIDE; CLASSIFICATION; SUBTYPES;
D O I：
10.18632/oncotarget.13549
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Pathologic complete response (pCR) prediction after neoadjuvant chemotherapy (NAC) is important for clinical decision-making in breast cancer. This study investigated the predictive value of Nottingham prognostic index (NPI), Immunohistochemical four (IHC4) score and a new predictive index combined with them in estrogen-positive (ER+) breast cancer following NAC. We retrospectively gathered clinical data of 739 ER+ breast cancer patients who received NAC from two cancer centers. We developed a new predictive biomarker named NPI+IHC4 to predict pCR in ER+ breast cancer in a training set (n=443) and validated it in an external validation set (n=296). The results showed that a lower IHC4 score, NPI and NPI+IHC4 were significantly associated a high pCR rate in the entire cohort. In the study set, NPI+IHC4 showed a better sensitivity and specificity for pCR prediction (AUC 0.699, 95% CI 0.626-0.772) than IHC4 score (AUC 0.613, 95% CI 0.533-0.692), NPI (AUC 0.576, 95% CI 0.494-0.659), tumor size (AUC 0.556, 95% CI 0.481-0.631) and TNM stage (AUC 0.521, 95% CI 0.442-0.601). In the validation set, NPI+ IHC4 had a better predictive value for pCR (AUC 0.665, 95% CI 0.579-0.751) than IHC4 score or NPI alone. In addition, ER+ patients with lower IHC4, NPI and NPI+ IHC4 scores had significantly better DFS in both study and validation sets. In summary, NPI+ IHC4 can predict pCR following NAC and prognosis in ER+ breast cancer, which is cost-effect and potentially more useful in guiding decision-making regarding NAC in clinical practice. Further validation is needed in prospective clinical trials with larger cohorts of patients.
引用
收藏
页码：87312 / 87322
页数：11
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