Age-Independent Preoperative Chemosensitivity and 5-Year Outcome Determined by Combined 70-and 80-Gene Signature in a Prospective Trial in Early-Stage Breast Cancer

被引：7

作者：

Whitworth, Pat ^{[1
,2
]}

Beitsch, Peter D. ^{[2
,3
]}

Pellicane, James, V ^{[4
]}

Baron, Paul L. ^{[5
,6
]}

Lee, Laura A. ^{[7
]}

Dul, Carrie L. ^{[8
]}

Nash, Charles H., III ^{[9
]}

Murray, Mary K. ^{[10
,11
]}

Richards, Paul D. ^{[12
]}

Gittleman, Mark ^{[13
]}

Budway, Raye ^{[14
]}

Rahman, Rakhshanda Layeequr ^{[15
]}

Kelemen, Pond ^{[16
,17
]}

Dooley, William C. ^{[18
,19
]}

Rock, David T. ^{[20
,21
]}

Cowan, Ken ^{[22
]}

Lesnikoski, Beth-Ann ^{[23
,24
]}

Barone, Julie L. ^{[25
,26
]}

Ashikari, Andrew Y. ^{[16
,27
,28
,29
]}

Dupree, Beth ^{[30
]}

Wang, Shiyu ^{[31
]}

Menicucci, Andrea R. ^{[31
]}

Yoder, Erin B. ^{[31
]}

Finn, Christine ^{[31
]}

Corcoran, Kate ^{[31
]}

Blumencranz, Lisa E. ^{[31
]}

Audeh, William ^{[31
]}

机构：

[1] Nashville Breast Ctr, Nashville, TN USA

[2] Targeted Med Educ, Cupertino, CA USA

[3] Dallas Surg Grp, Dallas, TX USA

[4] Bon Secours Canc Inst, Richmond, VA USA

[5] Breast & Melanoma Specialist Charleston, Charleston, SC USA

[6] Lenox Hill Hosp, Northwell Hlth, New York, NY 10021 USA

[7] Comprehens Canc Ctr, Palm Springs, CA USA

[8] Ascens St John Hosp Great Lakes Canc Management S, Grosse Pointe Woods, MI USA

[9] Northeast Georgia Med Ctr, Gainesville, GA USA

[10] Akron Gen Med Ctr, Akron, OH USA

[11] Cleveland Clin Akron Gen, Akron, OH USA

[12] Blue Ridge Canc Ctr, Roanoke, VA USA

[13] Breast Care Specialists, Allentown, PA USA

[14] St Clair Hosp, Pittsburgh, PA USA

[15] Texas Tech Univ, Lubbock, TX 79409 USA

[16] Ashikari Breast Ctr, Sleepy Hollow, NY USA

[17] Hofstra Univ, Zucker Sch Med, Hempstead, NY 11550 USA

[18] Univ Oklahoma Hlth Sci, Breast Inst, Oklahoma City, OK USA

[19] Stephenson Canc Ctr, Oklahoma City, OK USA

[20] Reg Breast Care, Ft Myers, FL USA

[21] Genesis Care, Ft Myers, FL USA

[22] Univ Nebraska Med Ctr, Omaha, NE USA

[23] JFK Med Ctr, Breast Inst, Atlantis, FL USA

[24] Baptist MD Anderson Canc Ctr, Jacksonville, FL USA

[25] Exempla St Joseph Hosp, Denver, CO USA

[26] Vail Hlth, Vail, CO USA

[27] New York Med Coll, Valhalla, NY 10595 USA

[28] Northwell Hlth Phys Partners, Mt Kisco, NY USA

[29] Phelps & Northern Westchester Hosp, Westchester, NY USA

[30] St Mary Med Alliance Canc Specialists, Langhorne, PA USA

[31] Agendia Inc, Irvine, CA 92618 USA

来源：

ANNALS OF SURGICAL ONCOLOGY | 2022年 / 29卷 / 07期

关键词：

TREATMENT DECISIONS; 70-GENE SIGNATURE; MAMMAPRINT; BLUEPRINT; PROFILE; AID;

D O I：

10.1245/s10434-022-11666-2

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background The Neoadjuvant Breast Symphony Trial (NBRST) demonstrated the 70-gene risk of distant recurrence signature, MammaPrint, and the 80-gene molecular subtyping signature, BluePrint, precisely determined preoperative pathological complete response (pCR) in breast cancer patients. We report 5-year follow-up results in addition to an exploratory analysis by age and menopausal status. Methods The observational, prospective NBRST (NCT01479101) included 954 early-stage breast cancer patients aged 18-90 years who received neoadjuvant chemotherapy and had clinical and genomic data available. Chemosensitivity and 5-year distant metastasis-free survival (DMFS) and overall survival (OS) were assessed. In a post hoc subanalysis, results were stratified by age (<= 50 vs. > 50 years) and menopausal status in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) tumors. Results MammaPrint and BluePrint further classified 23% of tumors to a different subtype compared with immunohistochemistry, with more precise correspondence to pCR rates. Five-year DMFS and OS were highest in MammaPrint Low Risk, Luminal A-type and HER2-type tumors, and lowest in MammaPrint High Risk, Luminal B-type and Basal-type tumors. There was no significant difference in chemosensitivity between younger and older patients with Low-Risk (2.2% vs. 3.8%; p = 0.64) or High-Risk tumors (14.5% vs. 11.5%; p = 0.42), or within each BluePrint subtype; this was similar when stratifying by menopausal status. The 5-year outcomes were comparable by age or menopausal status for each molecular subtype. Conclusion Intrinsic preoperative chemosensitivity and long-term outcomes were precisely determined by BluePrint and MammaPrint regardless of patient age, supporting the utility of these assays to inform treatment and surgical decisions in early-stage breast cancer.

引用

页码：4141 / 4152

页数：12

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