PREDICT underestimates survival of patients with HER2-positive early-stage breast cancer

被引：10

作者：

Agostinetto, Elisa ^{[1
,2
,3
]}

Ameye, Lieveke ^{[4
]}

Martel, Samuel ^{[5
]}

Aftimos, Philippe ^{[6
]}

Ponde, Noam ^{[7
]}

Maurer, Christian ^{[8
]}

El-Abed, Sarra ^{[9
]}

Wang, Yingbo ^{[10
]}

Vicente, Malou ^{[11
]}

Chumsri, Saranya ^{[12
]}

Bliss, Judith ^{[13
]}

Kroep, Judith ^{[14
]}

Colleoni, Marco ^{[15
]}

Petrelli, Fausto ^{[16
]}

Del Mastro, Lucia ^{[17
,18
]}

Moreno-Aspitia, Alvaro ^{[12
]}

Piccart, Martine ^{[11
]}

Paesmans, Marianne ^{[4
]}

de Azambuja, Evandro ^{[1
,2
]}

Lambertini, Matteo ^{[17
,18
]}

机构：

[1] Univ Libre Bruxelles ULB, Acad Trials Promoting Team, Brussels, Belgium

[2] Univ Libre Bruxelles ULB, Inst Jules Bordet, Brussels, Belgium

[3] Humanitas Univ, Dept Biomed Sci, Via Rita Levi Montalcini 4, I-20090 Milan, Italy

[4] Inst Jules Bordet, Ctr Data, Brussels, Belgium

[5] Univ Sherbrooke, Dept Hematooncol, CISSS Monteregie Ctr, Hop Charles Moyne, Greenfield Pk, PQ, Canada

[6] Univ Libre Bruxelles, Clin Trials Conduct Unit, Inst Jules Bordet, Brussels, Belgium

[7] AC Camargo Canc Ctr, Dept Clin Oncol, Sao Paulo, Brazil

[8] Univ Cologne, Dept Internal Med, Ctr Integrated Oncol Aachen Bonn Cologne Dusseldo, Cologne, Germany

[9] Breast Int Grp BIG, Brussels, Belgium

[10] Novartis Pharma AG, Basel, Switzerland

[11] Univ Libre Bruxelles, Inst Jules Bordet, Brussels, Belgium

[12] Mayo Clin, Robert & Monica Jacoby Ctr Breast Hlth, Jacksonville, FL USA

[13] Inst Canc Res, Clin Trials & Stat Unit, London, England

[14] Leiden Univ, Dept Med Oncol, Med Ctr, POB 9600, NL-2300 RC Leiden, Netherlands

[15] IRCCS, IEO European Inst Oncol, Milan, Italy

[16] ASST Bergamo Ovest, Oncol Unit, Treviglio, BG, Italy

[17] IRCCS Osped Policlin San Martino, Clin Oncol med, Dept Med Oncol, Genoa, Italy

[18] Univ Genoa, Sch Med, Dept Internal Med & Med Specialties DiMI, Genoa, Italy

来源：

NPJ BREAST CANCER | 2022年 / 8卷 / 01期

基金：

美国国家卫生研究院;

关键词：

RANDOMIZED CONTROLLED-TRIALS; PLUS ADJUVANT CHEMOTHERAPY; 70-GENE SIGNATURE; PROGNOSTIC MODEL; FOLLOW-UP; TRASTUZUMAB; VALIDATION; LAPATINIB;

D O I：

10.1038/s41523-022-00452-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The prognostic performance of PREDICT in patients with HER2-positive early breast cancer (EBC) treated in the modern era with effective chemotherapy and anti-HER2 targeted therapies is unclear. Therefore, we investigated its prognostic performance using data extracted from ALTTO, a phase III trial evaluating adjuvant lapatinib +/- trastuzumab vs. trastuzumab alone in patients with HER2-positive EBC. Our analysis included 2794 patients. After a median follow-up of 6.0 years (IQR, 5.8-6.7), 182 deaths were observed. Overall, PREDICT underestimated 5-year OS by 6.7% (95% CI, 5.8-7.6): observed 5-year OS was 94.7% vs. predicted 88.0%. The underestimation was consistent across all subgroups, including those according to the type of anti HER2-therapy. The highest absolute differences were observed for patients with hormone receptor negative-disease, nodal involvement, and large tumor size (13.0%, 15.8%, and 15.3%, respectively). AUC under the ROC curve was 73.7% (95% CI 69.7-77.8) in the overall population, ranging between 61.7% and 77.7% across the analyzed subgroups. In conclusion, our analysis showed that PREDICT highly underestimated OS in HER2-positive EBC. Hence, it should be used with caution to give prognostic estimation to HER2-positive EBC patients treated in the modern era with effective chemotherapy and anti-HER2 targeted therapies.

引用

页数：8

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