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.
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
04 Apr 2022
04 Apr 2022
Historique:
received:
11
10
2021
accepted:
07
03
2022
entrez:
5
4
2022
pubmed:
6
4
2022
medline:
6
4
2022
Statut:
aheadofprint
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 35378634
doi: 10.1245/s10434-022-11666-2
pii: 10.1245/s10434-022-11666-2
pmc: PMC9174138
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2022. The Author(s).
Références
Transl Oncol. 2020 Apr;13(4):100756
pubmed: 32208353
Breast Cancer Res Treat. 2012 May;133(1):37-47
pubmed: 21814749
J Surg Oncol. 1983 Apr;22(4):278-82
pubmed: 6834850
Nature. 2002 Jan 31;415(6871):530-6
pubmed: 11823860
Breast Cancer Res Treat. 2013 Jun;139(3):759-67
pubmed: 23756626
Nature. 2000 Aug 17;406(6797):747-52
pubmed: 10963602
N Engl J Med. 2016 Aug 25;375(8):717-29
pubmed: 27557300
Breast Cancer Res Treat. 2018 Jan;167(1):123-131
pubmed: 28929359
Breast Cancer Res Treat. 2015 Nov;154(1):81-8
pubmed: 26424167
NPJ Breast Cancer. 2019 Apr 18;5:15
pubmed: 31016233
N Engl J Med. 2002 Dec 19;347(25):1999-2009
pubmed: 12490681
JAMA Oncol. 2019 Sep 01;5(9):1304-1309
pubmed: 31393518
Ann Surg Oncol. 2017 Mar;24(3):669-675
pubmed: 27770345
Ann Surg Oncol. 2017 Sep;24(9):2539-2546
pubmed: 28447218
BMC Genomics. 2006 Oct 30;7:278
pubmed: 17074082
Breast Cancer Res Treat. 2019 Feb;173(3):533-543
pubmed: 30361874
J Surg Oncol. 2009 Sep 1;100(3):248-51
pubmed: 19330813
J Clin Oncol. 2013 Nov 1;31(31):3997-4013
pubmed: 24101045
Lancet Oncol. 2021 Apr;22(4):476-488
pubmed: 33721561
Biomark Insights. 2010 Nov 28;5:129-38
pubmed: 21151591
J Natl Compr Canc Netw. 2014 Apr;12(4):542-90
pubmed: 24717572
Genes Chromosomes Cancer. 2022 Mar;61(3):148-160
pubmed: 34841595
Proc Natl Acad Sci U S A. 2001 Sep 11;98(19):10869-74
pubmed: 11553815
Oncotarget. 2016 Oct 4;7(40):65024-65033
pubmed: 27542253
J Clin Oncol. 2007 Jan 1;25(1):118-45
pubmed: 17159189
Ann Surg Oncol. 2014 Oct;21(10):3261-7
pubmed: 25099655
N Engl J Med. 2019 Jun 20;380(25):2395-2405
pubmed: 31157962