Breast Cancer Index predicts pathological complete response and eligibility for breast conserving surgery in breast cancer patients treated with neoadjuvant chemotherapy

Mathieu, Marie‐Christine; Mazouni, Chafika; Kesty, Nicole C.; Zhang, Y.; Scott, Véronique; Passeron, Jean Claude; Arnedos, Mónica; Schnabel, Catherine A.; Delaloge, Suzette; Erlander, Mark G.; André, Fabrice

doi:10.1093/annonc/mdr550

Cited by 37 publications

(18 citation statements)

References 23 publications

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“…BCI is an algorithmic gene expression-based signature that linearly integrates the tumor expression of the MGI and the expression ratio of HOXB13/IL17BR (H/I; refs. 9,13,20). MGI is the additive expression values of 5 cell-cycle genes for quantification of tumor grade and has been shown to be a significant prognostic for ER þ LN À patients (12).…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Index Identifies Early-Stage Estrogen Receptor–Positive Breast Cancer Patients at Risk for Early- and Late-Distant Recurrence

Zhang

Schnabel

Schroeder

et al. 2013

Clinical Cancer Research

200

179

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Purpose: Residual risk of relapse remains a substantial concern for patients with hormone receptorpositive breast cancer, with approximately half of all disease recurrences occurring after five years of adjuvant antiestrogen therapy.Experimental Design: The objective of this study was to examine the prognostic performance of an optimized model of Breast Cancer Index (BCI), an algorithmic gene expression-based signature, for prediction of early (0-5 years) and late (>5 years) risk of distant recurrence in patients with estrogen receptor-positive (ER þ ), lymph node-negative (LN À ) tumors. The BCI model was validated by retrospective analyses of tumor samples from tamoxifen-treated patients from a randomized prospective trial (Stockholm TAM, n ¼ 317) and a multi-institutional cohort (n ¼ 358).Results: Within the Stockholm TAM cohort, BCI risk groups stratified the majority ($65%) of patients as low risk with less than 3% distant recurrence rate for 0 to 5 years and 5 to 10 years. In the multi-institutional cohort, which had larger tumors, 55% of patients were classified as BCI low risk with less than 5% distant recurrence rate for 0 to 5 years and 5 to 10 years. For both cohorts, continuous BCI was the most significant prognostic factor beyond standard clinicopathologic factors for 0 to 5 years and more than five years.Conclusions: The prognostic sustainability of BCI to assess early-and late-distant recurrence risk at diagnosis has clinical use for decisions of chemotherapy at diagnosis and for decisions for extended adjuvant endocrine therapy beyond five years. Clin Cancer Res; 19(15); 4196-205. Ó2013 AACR.

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Section: Discussionmentioning

confidence: 99%

Breast Cancer Index Identifies Early-Stage Estrogen Receptor–Positive Breast Cancer Patients at Risk for Early- and Late-Distant Recurrence

Zhang

Schnabel

Schroeder

et al. 2013

Clinical Cancer Research

200

179

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“…In recent years, RNA expression-based classification of tumors has become an attractive standardized approach to aiding in the diagnosis and subclassification of tumors [19][20][21][22][23][24][25] and for individualized therapy applications. [26][27][28] In the coming years, gene expressionbased analysis may serve as a complementary approach to genome-wide DNA analysis of tumors for individualized therapy.…”

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confidence: 99%

A 92-gene cancer classifier predicts the site of origin for neuroendocrine tumors

Kerr

Schnabel²,

Sullivan

et al. 2014

Modern Pathology

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A diagnosis of neuroendocrine carcinoma is often morphologically straight-forward; however, the tumor site of origin may remain elusive in a metastatic presentation. Neuroendocrine tumor subtyping has important implications for staging and patient management. In this study, the novel use and performance of a 92-gene molecular cancer classifier for determination of the site of tumor origin are described in a series of 75 neuroendocrine tumors (44 metastatic, 31 primary; gastrointestinal (n ¼ 12), pulmonary (n ¼ 22), Merkel cell (n ¼ 10), pancreatic (n ¼ 10), pheochromocytoma (n ¼ 10), and medullary thyroid carcinoma (n ¼ 11)). Formalinfixed, paraffin-embedded samples passing multicenter pathologist adjudication were blinded and tested by a 92-gene molecular assay that predicts tumor type/subtype based upon relative quantitative PCR expression measurements for 87 tumor-related and 5 reference genes.

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“…Compared with previous studies involving patients with all types of breast cancer and identifying the subtype as a key predictor [3][4][5][6]12,13], the current study has valuable implications because our nomogram can be specifically applied to patients with HR-positive, HER2-negative cancer, which is believed to be less responsive to NAC and has a low probability of successful BCS.…”

Section: Discussionmentioning

confidence: 99%

Predicting Successful Conservative Surgery after Neoadjuvant Chemotherapy in Hormone Receptor-Positive, HER2-Negative Breast Cancer

Kim

Lee

et al. 2018

J Breast Dis

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Purpose: This study aimed to determine whether clinicopathological factors are potentially associated with successful breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) and develop a nomogram for predicting successful BCS candidates, focusing on those who are diagnosed with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative tumors during the pre-NAC period. Methods: The training cohort included 239 patients with an HR-positive, HER2-negative tumor (≥ 3 cm), and all of these patients had received NAC. Patients were excluded if they met any of the following criteria: diffuse, suspicious, malignant microcalcification (extent > 4 cm); multicentric or multifocal breast cancer; inflammatory breast cancer; distant metastases at the time of diagnosis; excisional biopsy prior to NAC; and bilateral breast cancer. Multivariate logistic regression analysis was conducted to evaluate the possible predictors of BCS eligibility after NAC, and the regression model was used to develop the predicting nomogram. This nomogram was built using the training cohort (n= 239) and was later validated with an independent validation cohort (n= 123). Results: Small tumor size (p< 0.001) at initial diagnosis, long distance from the nipple (p= 0.002), high body mass index (p= 0.001), and weak positivity for progesterone receptor (p= 0.037) were found to be four independent predictors of an increased probability of BCS after NAC; further, these variables were used as covariates in developing the nomogram. For the training and validation cohorts, the areas under the receiver operating characteristic curve were 0.833 and 0.786, respectively; these values demonstrate the potential predictive power of this nomogram. Conclusion: This study established a new nomogram to predict successful BCS in patients with HR-positive, HER2-negative breast cancer. Given that chemotherapy is an option with unreliable outcomes for this subtype, this nomogram may be used to select patients for NAC followed by successful BCS.data from the U.S. National Cancer Database [6], ER negativity is considered to be one of the key factors associated with a high probability of successful breast conservation. Accordingly, surgeons expect that ORIGINAL ARTICLE J Breast Dis 2018 December; 6(2): 52-59 https://doi.

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Breast Cancer Index predicts pathological complete response and eligibility for breast conserving surgery in breast cancer patients treated with neoadjuvant chemotherapy

Cited by 37 publications

References 23 publications

Breast Cancer Index Identifies Early-Stage Estrogen Receptor–Positive Breast Cancer Patients at Risk for Early- and Late-Distant Recurrence

Breast Cancer Index Identifies Early-Stage Estrogen Receptor–Positive Breast Cancer Patients at Risk for Early- and Late-Distant Recurrence

A 92-gene cancer classifier predicts the site of origin for neuroendocrine tumors

Predicting Successful Conservative Surgery after Neoadjuvant Chemotherapy in Hormone Receptor-Positive, HER2-Negative Breast Cancer

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