PAM-50 predicts local recurrence after breast cancer surgery in postmenopausal patients with ER+/HER2- disease: results from 1204 patients in the randomized ABCSG-8 trial.
Age Factors
Aged
Anastrozole
/ therapeutic use
Antineoplastic Agents, Hormonal
/ therapeutic use
Breast Neoplasms
/ genetics
Chemotherapy, Adjuvant
Female
Gene Expression Profiling
/ methods
Humans
Lymph Nodes
/ pathology
Mastectomy, Segmental
Neoplasm Grading
Neoplasm Recurrence, Local
/ genetics
Postmenopause
Prognosis
Radiotherapy, Adjuvant
Receptor, ErbB-2
/ metabolism
Receptors, Estrogen
/ metabolism
Tamoxifen
/ therapeutic use
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
05 04 2021
05 04 2021
Historique:
received:
10
03
2020
accepted:
18
10
2020
pubmed:
21
2
2021
medline:
11
8
2021
entrez:
20
2
2021
Statut:
ppublish
Résumé
The aim of this study was to investigate whether the PAM-50-based 46-gene assay carries prognostic value for risk of local recurrence of breast cancer. The Austrian Breast and Colorectal Cancer Study Group (ABCSG) 8 RCT compared 5 years of tamoxifen with tamoxifen for 2 years followed by anastrozole for 3 years in postmenopausal women with endocrine receptor-positive breast cancer. This study included patients from the trial who had breast-conserving surgery for whom tumour blocks were available for PAM-50 analysis. Tumour blocks from 1204 patients who had breast-conserving surgery were available for the PAM-50 analysis, and 1034 of these received radiotherapy. After a median follow-up of 10.8 years, 23 local events had been observed, corresponding to an overall local recurrence risk of 2.2 per cent. Univariable competing-risk analysis demonstrated that patients at low risk according to PAM-50 analysis (risk-of-recurrence (ROR) score less than 57) had a significantly lower incidence of local recurrence than those in the high-risk group at 5 years (0.1 (95 per cent c.i. 0 to 0.7) versus 2.2 (0.9 to 4.6) per cent respectively; subhazard ratio (SHR) 17.18, 95 per cent c.i. 2.06 to 142.88; P = 0.009) and 10 years (0.9 (0.4 to 2.0) versus 3.8 (1.9 to 6.6) per cent; SHR 4.76, 1.72 to 13.17; P = 0.003). Multivariable analyses that included ROR score, age, tumour size, nodal status, type of surgery, tumor grade, and trial-specific endocrine therapy confirmed that ROR score was an independent prognostic factor for risk of local recurrence. Analysis of the women randomized to radiotherapy or control after breast conservation showed that PAM-50 was not predictive of radiotherapy effect. PAM-50 can be used as a prognostic tool for local recurrence risk in postmenopausal women with hormone receptor-positive breast cancer treated with endocrine therapy. The test was not predictive for the benefit of radiotherapy.
Sections du résumé
BACKGROUND
The aim of this study was to investigate whether the PAM-50-based 46-gene assay carries prognostic value for risk of local recurrence of breast cancer.
METHODS
The Austrian Breast and Colorectal Cancer Study Group (ABCSG) 8 RCT compared 5 years of tamoxifen with tamoxifen for 2 years followed by anastrozole for 3 years in postmenopausal women with endocrine receptor-positive breast cancer. This study included patients from the trial who had breast-conserving surgery for whom tumour blocks were available for PAM-50 analysis.
RESULTS
Tumour blocks from 1204 patients who had breast-conserving surgery were available for the PAM-50 analysis, and 1034 of these received radiotherapy. After a median follow-up of 10.8 years, 23 local events had been observed, corresponding to an overall local recurrence risk of 2.2 per cent. Univariable competing-risk analysis demonstrated that patients at low risk according to PAM-50 analysis (risk-of-recurrence (ROR) score less than 57) had a significantly lower incidence of local recurrence than those in the high-risk group at 5 years (0.1 (95 per cent c.i. 0 to 0.7) versus 2.2 (0.9 to 4.6) per cent respectively; subhazard ratio (SHR) 17.18, 95 per cent c.i. 2.06 to 142.88; P = 0.009) and 10 years (0.9 (0.4 to 2.0) versus 3.8 (1.9 to 6.6) per cent; SHR 4.76, 1.72 to 13.17; P = 0.003). Multivariable analyses that included ROR score, age, tumour size, nodal status, type of surgery, tumor grade, and trial-specific endocrine therapy confirmed that ROR score was an independent prognostic factor for risk of local recurrence. Analysis of the women randomized to radiotherapy or control after breast conservation showed that PAM-50 was not predictive of radiotherapy effect.
CONCLUSION
PAM-50 can be used as a prognostic tool for local recurrence risk in postmenopausal women with hormone receptor-positive breast cancer treated with endocrine therapy. The test was not predictive for the benefit of radiotherapy.
Identifiants
pubmed: 33608712
pii: 6145316
doi: 10.1093/bjs/znaa089
pmc: PMC10364863
doi:
Substances chimiques
Antineoplastic Agents, Hormonal
0
Receptors, Estrogen
0
Tamoxifen
094ZI81Y45
Anastrozole
2Z07MYW1AZ
Receptor, ErbB-2
EC 2.7.10.1
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
308-314Commentaires et corrections
Type : ErratumIn
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.
Références
Crit Rev Oncol Hematol. 2011 Jun;78(3):260-4
pubmed: 20447833
Eur J Cancer. 2020 Mar;127:12-20
pubmed: 31962198
Int J Radiat Oncol Biol Phys. 2007 Jun 1;68(2):334-40
pubmed: 17363187
Ann Oncol. 2015 Aug;26(8):1685-91
pubmed: 25935792
Ann Oncol. 2019 Oct 1;30(10):1541-1557
pubmed: 31373601
BMC Med Genomics. 2015 Aug 22;8:54
pubmed: 26297356
J Clin Oncol. 2013 Aug 1;31(22):2783-90
pubmed: 23816962
Breast Cancer Res Treat. 2014 Dec;148(3):599-613
pubmed: 25414025
Ann Oncol. 2014 Feb;25(2):339-45
pubmed: 24347518
N Engl J Med. 2004 Sep 2;351(10):971-7
pubmed: 15342805
Eur J Cancer. 2013 Jul;49(10):2294-302
pubmed: 23523089
Br J Cancer. 2015 Apr 14;112(8):1405-10
pubmed: 25867274
Br J Cancer. 2007 Apr 10;96(7):1025-9
pubmed: 17285133
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
Lancet Oncol. 2015 Mar;16(3):266-73
pubmed: 25637340
J Clin Oncol. 2015 Mar 10;33(8):916-22
pubmed: 25332252
J Clin Oncol. 2010 Apr 1;28(10):1677-83
pubmed: 20065188
J Clin Oncol. 2013 Jul 1;31(19):2382-7
pubmed: 23690420
J Clin Oncol. 2012 Mar 1;30(7):722-8
pubmed: 22271481