Impact of the EndoPredict genomic assay on treatment decisions for oestrogen receptor-positive early breast cancer patients: benefits of physician selective testing.

Breast Neoplasms / diagnosis Chemotherapy, Adjuvant Cohort Studies Female Genomics Humans Physicians Prognosis Receptor, ErbB-2 / genetics Receptors, Estrogen / genetics
Early breast cancer EndoPredict Endocrine therapy Prognosis Prognostic signatures Treatment decision

Journal

Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104

Informations de publication

Date de publication:
Feb 2022
Historique:
received: 30 09 2021
accepted: 14 11 2021
pubmed: 3 12 2021
medline: 15 2 2022
entrez: 2 12 2021
Statut: ppublish

Résumé

Genomic tests improve accuracy of risk prediction for early breast cancers but these are expensive. This study evaluated the clinical utility of EndoPredict®, in terms of impact on adjuvant therapy recommendations and identification of parameters to guide selective application. Patients with ER-positive, HER2-negative, and early-stage invasive breast cancer were tested with EndoPredict®. Two cohorts were recruited: one consecutively and another at clinical team discretion. Systemic treatment recommendations were recorded before and after EndoPredict® results were revealed to the multidisciplinary team. 233 patients were recruited across five sites: 123 consecutive and 110 at clinical team discretion. In the consecutive cohort 50.6% (62/123) cases were classified high risk of recurrence by EndoPredict®, compared with 62.7% (69/110) in the selective cohort. A change in treatment recommendation was significantly more likely (p < 0.0001) in the selective cohort (43/110, 39.1%) compared to the consecutive group (11/123, 8.9%). The strongest driver of selective recruitment was intermediate grade histology, whilst logistic regression modelling demonstrated that nodal status (p < 0.001), proliferative rate (p = 0.001), and progesterone receptor positivity (p < 0.001) were the strongest discriminators of risk. Whilst molecular risk can be predicted by traditional variables in a high proportion of cases, EndoPredict® had a greater impact on treatment decisions in those cases selected for testing at team discretion. This is indicative of the robust ability of the clinical team to identify cases most likely to benefit from testing, underscoring the value of genomic tests in the oncologists' tool kit.

Identifiants

DOI: 10.1007/s10549-021-06456-5 PMID: 34853987
pubmed: 34853987
doi: 10.1007/s10549-021-06456-5
pii: 10.1007/s10549-021-06456-5
doi:

Substances chimiques

Receptors, Estrogen 0
Receptor, ErbB-2 EC 2.7.10.1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

501-511

Informations de copyright

© 2021. Crown.

Références

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Auteurs

Phuong Dinh (P)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

J Dinny Graham (JD)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Elisabeth N Elder (EN)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Masrura Kabir (M)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.

Tram B Doan (TB)

The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, 2145, Australia.

James French (J)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Farid Meybodi (F)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Rina Hui (R)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Nicholas R Wilcken (NR)

Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Paul R Harnett (PR)

Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Jeremy Hsu (J)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Kirsty E Stuart (KE)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Tim Wang (T)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia.
Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Verity Ahern (V)

Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Meagan Brennan (M)

Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia.

Stephen B Fox (SB)

Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.

Rachel F Dear (RF)

St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, NSW, 2010, Australia.

Elgene Lim (E)

St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, NSW, 2010, Australia.
Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia.

Michelle White (M)

Monash Health, Clayton, VIC, 3168, Australia.

G Bruce Mann (GB)

Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.
Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.

Nirmala Pathmanathan (N)

Westmead Breast Cancer Institute, Westmead, NSW, 2145, Australia. Nirmala.pathmanathan@health.nsw.gov.au.
Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia. Nirmala.pathmanathan@health.nsw.gov.au.
Douglass Hanly Moir Pathology, Macquarie Park, NSW, 2113, Australia. Nirmala.pathmanathan@health.nsw.gov.au.
ORCID: 0000-0001-9225-139X

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Classifications MeSH

questionsmedicales.fr › Maladies de la peau et du tissu conjonctif › Maladies de la peau › Maladies du sein › Tumeurs du sein › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Traitement médicamenteux adjuvant › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Disciplines des sciences naturelles › Disciplines des sciences biologiques › Biologie › Génétique › Génomique › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › Médecins › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Diagnostic › Pronostic › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Facteurs biologiques › Marqueurs biologiques › Marqueurs biologiques tumoraux › Récepteur ErbB-2 › Impact of the EndoPredict genomic assay on...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Facteurs de transcription › Récepteurs aux stéroïdes › Récepteurs des oestrogènes › Impact of the EndoPredict genomic assay on...