PAM50 Risk of Recurrence Score Predicts 10-Year Distant Recurrence in a Comprehensive Danish Cohort of Postmenopausal Women Allocated to 5 Years of Endocrine Therapy for Hormone Receptor-Positive Early Breast Cancer

被引：118

作者：

Laenkholm, Anne-Vibeke ^{[1
]}

Jensen, Maj-Britt ^{[2
]}

Eriksen, Jens Ole ^{[1
]}

Rasmussen, Birgitte Bruun ^{[3
]}

Knoop, Ann S. ^{[2
]}

Buckingham, Wesley ^{[6
]}

Ferree, Sean ^{[6
]}

Schaper, Carl ^{[6
]}

Nielsen, Torsten O. ^{[7
]}

Haffner, Taryn ^{[6
]}

Kibol, Torben ^{[1
]}

Talman, Maj-Lis Moller ^{[2
]}

Jylling, Anne Marie Bak ^{[4
]}

Tabor, Tomasz Piotr ^{[5
]}

Ejlertsen, Bent ^{[2
]}

机构：

[1] Zealand Univ Hosp, Slagelse, Denmark

[2] Rigshosp, Copenhagen, Denmark

[3] Herlev Hosp, Herlev, Denmark

[4] Odense Univ Hosp, Odense, Denmark

[5] Vejle Hosp, Vejle, Denmark

[6] NanoString Technol, Seattle, WA USA

[7] Univ British Columbia, Vancouver, BC, Canada

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2018年 / 36卷 / 08期

关键词：

INTERNATIONAL EXPERT CONSENSUS; AMERICAN SOCIETY; ONCOTYPE DX; TAMOXIFEN; BIOMARKERS; SIGNATURE; DECISIONS; ABCSG-8; ASSAY; IHC4;

D O I：

10.1200/JCO.2017.74.6586

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PurposeThe PAM50-based Prosigna risk of recurrence (ROR) score has been validated in randomized clinical trials to predict 10-year distant recurrence (DR). The value of Prosigna for predicting DR was examined in a comprehensive nationwide Danish cohort consisting of postmenopausal women with hormone receptor-positive early breast cancer treated with 5 years of endocrine therapy alone.Patients and MethodsUsing the population-based Danish Breast Cancer Cooperative Group database, follow-up data were collected on all patients diagnosed from 2000 through 2003 who, by nationwide guidelines, were treated with endocrine therapy for 5 years. Primary tumor blocks from 2,740 patients were tested with Prosigna and, after determination of human epidermal growth factor receptor 2 (HER2) status, data from 2,558 hormone receptor-positive/HER2-negative samples were analyzed, including 1,395 node-positive patients. Fine and Gray models were applied to determine the prognostic value of ROR for DR.ResultsMedian follow-up for recurrence was 9.2 years. Twenty-six percent of the node-positive patients were classified as low ROR (n = 359) with a DR risk of 3.5% (95% confidence interval [CI], 1.9% to 6.1%) versus a DR risk of 22.1% (95% CI, 18.6% to 25.8%) at 10 years for patients classified as high ROR (n = 648). Node-negative patients classified as low and high ROR had a risk of DR of 5.0% (95% CI, 2.9% to 8.0%) and 17.8% (95% CI, 14.0% to 22.0%), respectively. Luminal B tumors (n = 947; DR risk, 18.4% [95% CI: 15.7% to 21.3%]) had a significantly worse outcome than luminal A tumors (n = 1,474,;DR risk, 7.6% [95% CI: 6.1% to 9.2%]; P < .001).ConclusionProsigna ROR score improved the prediction of outcome in this nationwide Danish population. In a real-world setting, Prosigna can reliably identify node-negative patients and a significant proportion of patients with one to three positive nodes who can be spared treatment with adjuvant chemotherapy. (C) 2018 by American Society of Clinical Oncology

引用

页码：735 / +

页数：9

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