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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Vydáno v:	Breast cancer research and treatment Ročník 120; číslo 3; s. 655 - 661
Hlavní autoři:	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
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Boston Boston : Springer US 01.04.2010 Springer US Springer Springer Nature B.V Springer Verlag
Témata:	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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Shrnutí:	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.
Bibliografie:	http://dx.doi.org/10.1007/s10549-010-0814-2 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-1 ObjectType-Feature-2 content type line 23
ISSN:	0167-6806 1573-7217 1573-7217
DOI:	10.1007/s10549-010-0814-2