predictive value of the 70-gene signature for adjuvant chemotherapy in early breast cancer

Multigene assays have been developed and validated to determine the prognosis of breast cancer. In this study, we assessed the additional predictive value of the 70-gene MammaPrint signature for chemotherapy (CT) benefit in addition to endocrine therapy (ET) from pooled study series. For 541 patient...

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Bibliographic Details
Published in:Breast cancer research and treatment Vol. 120; no. 3; pp. 655 - 661
Main Authors: Knauer, Michael, Mook, Stella, Rutgers, Emiel J. T, Bender, Richard A, Hauptmann, Michael, van de Vijver, Marc J, Koornstra, Rutger H. T, Bueno-de-Mesquita, Jolien M, Linn, Sabine C, van 't Veer, Laura J
Format: Journal Article
Language:English
Published: Boston Boston : Springer US 01.04.2010
Springer US
Springer
Springer Nature B.V
Springer Verlag
Subjects:
Adenocarcinoma - drug therapy
Adenocarcinoma - genetics
Adenocarcinoma - metabolism
Adenocarcinoma - pathology
Adenocarcinoma - radiotherapy
Adenocarcinoma - surgery
Adjuvant treatment
Adult
Aged
Analysis
Anthracyclines - administration & dosage
Antineoplastic Agents, Hormonal - administration & dosage
Antineoplastic Agents, Hormonal - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Breast cancer
Breast Neoplasms - drug therapy
Breast Neoplasms - genetics
Breast Neoplasms - metabolism
Breast Neoplasms - pathology
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Cancer
Cancer research
Cancer therapies
Care and treatment
Chemotherapy
Chemotherapy, Adjuvant
Clinical Trial
Clinical trials
Combined Modality Therapy
Endocrine therapy
Female
Gene expression
Gene Expression Profiling
Gene Expression Regulation, Neoplastic
Genes
Genetic aspects
Gynecology. Andrology. Obstetrics
Health aspects
Health risk assessment
Humans
Mammary gland diseases
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Invasiveness - genetics
Neoplasm Metastasis - genetics
Neoplasm Proteins - biosynthesis
Neoplasm Proteins - genetics
Neoplasm Staging
Oncology
Predictive Value of Tests
Prognosis
Radiotherapy, Adjuvant
Risk Assessment
Taxoids - administration & dosage
Tumor Burden
Tumors
Adjuvant chemotherapy
Breast cancer
Gene expression profiling
Risk assessment
Evaluation
Breast disease
Adjuvant treatment
Malignant tumor
Gene expression profile
Mammary gland diseases
Chemotherapy
Treatment
Risk factor
Predictive value
Early
Cancer
ISSN:0167-6806, 1573-7217, 1573-7217
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Summary:Multigene assays have been developed and validated to determine the prognosis of breast cancer. In this study, we assessed the additional predictive value of the 70-gene MammaPrint signature for chemotherapy (CT) benefit in addition to endocrine therapy (ET) from pooled study series. For 541 patients who received either ET (n = 315) or ET + CT (n = 226), breast cancer-specific survival (BCSS) and distant disease-free survival (DDFS) at 5 years were assessed separately for the 70-gene high and low risk groups. The 70-gene signature classified 252 patients (47%) as low risk and 289 (53%) as high risk. Within the 70-gene low risk group, BCSS was 97% for the ET group and 99% for the ET + CT group at 5 years with a non-significant univariate hazard ratio (HR) of 0.58 (95% CI 0.07-4.98; P = 0.62). In the 70-gene high risk group, BCSS was 81% (ET group) and 94% (ET + CT group) at 5 years with a significant HR of 0.21 (95% CI 0.07-0.59; P < 0.01). DDFS was 93% (ET) versus 99% (ET + CT), respectively, in the 70-gene low risk group, HR 0.26 (95% CI 0.03-2.02; P = 0.20). In the high risk group DDFS was 76 versus 88%, HR of 0.35 (95% CI 0.17-0.71; P < 0.01). Results were similar in multivariate analysis, showing significant survival benefit by adding CT in the 70-gene high risk group. A significant and clinically meaningful benefit was observed by adding chemotherapy to endocrine treatment in 70-gene high risk patients. This benefit was not significant in low risk patients, who were at such low risk for recurrence and cancer-related death, that adding CT does not appear to be clinically meaningful.
Bibliography:http://dx.doi.org/10.1007/s10549-010-0814-2
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ISSN:0167-6806
1573-7217
1573-7217
DOI:10.1007/s10549-010-0814-2