Breast cancer tumor heterogeneity has only little impact on the estimation of the Oncotype DX® recurrence score using Magee Equations and Magee Decision Algorithm™

Remoué, Annabelle; Conan‐Charlet, Virginie; Deiana, Laura; Tyulyandina, Alexandra; Marcorelles, Pascale; Schick, Ulrike; Uguen, Arnaud

doi:10.1016/j.humpath.2020.11.006

Cited by 2 publications

(3 citation statements)

References 36 publications

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“…For cases with residual disease, residual cancer burden score/category (whenever available) was correlated with ME3 scores [122]. The estimation of the recurrence score using Magee Equations and Magee Decision Algorithm TM has been validated retrospectively [123, 124]. Magee Equation 3 score ≥31 predicts pCR in the neoadjuvant setting and for tumour recurrence when pCR is not achieved [125].…”

Section: Modification Of Er Pr and Her2 Status During Bc Evolutionmentioning

confidence: 99%

Assessment of Predictive Biomarkers in Breast Cancer: Challenges and Updates

et al. 2022

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The management of patients with breast cancer (BC) relies on the assessment of a defined set of well-established prognostic and predictive markers. Despite overlap, prognostic markers are used to assess the risk of recurrence and the likely benefit of systemic therapy, whereas predictive markers are used to determine the type of systemic therapy to be offered to an individual patient. In this review, we provide an update and present some challenges in the assessment of the main BC-specific molecular predictive markers, namely hormone receptors (oestrogen receptor [ER] and progesterone receptor [PR]), human epidermal growth factor receptor 2 (HER2), and KI67. As the main platform for assessing these markers in BC is immunohistochemistry (IHC), we address the cut-off values used to define positivity, the ER-low subgroup, the existence and significance of the ER−/PR+ phenotype, the use of PR in routine practice, and the role of hormone receptors in ductal carcinoma in situ. We discuss the newly introduced HER2-low class of BC and the clinical/biological difference between different HER2 groups (e.g., HER2 IHC score 3+ BCs vs. those with a HER2 IHC score 2+ with <i>HER2</i> gene amplification). The review concludes with an update on the applications of KI67 assessment in BC and observations on the role of immune checkpoint identification in BC.

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Section: Modification Of Er Pr and Her2 Status During Bc Evolutionmentioning

confidence: 99%

Assessment of Predictive Biomarkers in Breast Cancer: Challenges and Updates

et al. 2022

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“…Now an app is also available for iOS devices (UPMC Magee Equations on the App Store). Since those original publications, other investigators have examined MEs in their practice and have found them useful 22–35 . We have utilized MEs to further validate and create a decision algorithm for triaging breast cancer cases and also tested its usefulness in the neoadjuvant setting.…”

Section: Validation and Magee Decision Algorithmmentioning

confidence: 99%

“…Since those original publications, other investigators have examined MEs in their practice and have found them useful. [22][23][24][25][26][27][28][29][30][31][32][33][34][35] We have utilized MEs to further validate and create a decision algorithm for triaging breast cancer cases and also tested its usefulness in the neoadjuvant setting. A brief overview of these internal studies is provided below.…”

Section: Validation and Magee Decision Algorithmmentioning

confidence: 99%

The Story of the Magee Equations: The Ultimate in Applied Immunohistochemistry

Bhargava

Dabbs

2022

Applied Immunohistochemistry &Amp; Molecular Morphology

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Magee equations (MEs) are a set of multivariable models that were developed to estimate the actual Oncotype DX (ODX) recurrence score in invasive breast cancer. The equations were derived from standard histopathologic factors and semiquantitative immunohistochemical scores of routinely used biomarkers. The 3 equations use slightly different parameters but provide similar results. ME1 uses Nottingham score, tumor size, and semiquantitative results for estrogen receptor (ER), progesterone receptor, HER2, and Ki-67. ME2 is similar to ME1 but does not require Ki-67. ME3 includes only semiquantitative immunohistochemical expression levels for ER, progesterone receptor, HER2, and Ki-67. Several studies have validated the clinical usefulness of MEs in routine clinical practice. The new cut-off for ODX recurrence score, as reported in the Trial Assigning IndividuaLized Options for Treatment trial, necessitated the development of Magee Decision Algorithm (MDA). MEs, along with mitotic activity score can now be used algorithmically to safely forgo ODX testing. MDA can be used to triage cases for molecular testing and has the potential to save an estimated $300,000 per 100 clinical requests. Another potential use of MEs is in the neoadjuvant setting to appropriately select patients for chemotherapy. Both single and multi-institutional studies have shown that the rate of pathologic complete response (pCR) to neoadjuvant chemotherapy in ER+/HER2-negative patients can be predicted by ME3 scores. The estimated pCR rates are 0%, <5%, 14%, and 35 to 40% for ME3 score <18, 18 to 25, >25 to <31, and 31 or higher, respectively. This information is similar to or better than currently available molecular tests. MEs and MDA provide valuable information in a time-efficient manner and are available free of cost for anyone to use. The latter is certainly important for institutions in resource-poor settings but is also valuable for large institutions and integrated health systems.

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Breast cancer tumor heterogeneity has only little impact on the estimation of the Oncotype DX® recurrence score using Magee Equations and Magee Decision Algorithm™

Cited by 2 publications

References 36 publications

Assessment of Predictive Biomarkers in Breast Cancer: Challenges and Updates

Assessment of Predictive Biomarkers in Breast Cancer: Challenges and Updates

The Story of the Magee Equations: The Ultimate in Applied Immunohistochemistry

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