Change in therapeutic management after the EndoPredict assay in a prospective decision impact study of Mexican premenopausal breast cancer patients

Abstract

Objective To evaluate the change in adjuvant therapeutic decision in a cohort of young women with breast cancer discussed by a multidisciplinary team, before and after EndoPredict testing. Patients and methods 99 premenopausal women with hormone receptor-positive, HER2-negative, T1-T2, and N0-N1 breast cancer were included. Clinicopathological characteristics were recorded and cases were presented in a multidisciplinary tumor board. Consensual therapeutic decisions before and after EndoPredict results were registered. Medical records were reviewed at six-month follow-up to determine physicians' adherence to therapeutic recommendations. Pearson chi-square and McNemar's tests were used to analyze differences between groups and changes in treatment recommendations, respectively. Results Median age at diagnosis was 43 years. The most frequent tumor size was pT2 (53.5%) and 27% of patients had 1-3 positive lymph nodes. 46% of patients had a low-risk EPclin result. Nodal status and tumor grade were significantly associated with EPclin result (p < .00001 and p = .0110, respectively), while Ki67 levels and age �40 years were not. A change in chemotherapy decision was registered in 19.2% of patients (p = .066), with the greatest impact in de-escalation (9% net reduction). A change in chemotherapy or endocrine therapy regimen was suggested in 19% and 20% of cases, respectively, after EPclin results were available. A significant difference was found in the median EPclin score between patients with a low-vs. high-intensity chemotherapy and endocrine therapy regimen

Concordance between Ki‑67 index in invasive breast cancer and molecular signatures: EndoPredict and MammaPrint

“…The proportion of patients with a high recurrence risk was higher in the EndoPredict cohort (56.25 vs. 30.00%, P<0.001). The median (interquartile range) Ki-67 index for the two cohorts in patients with high and low recurrence risk was 30 and 15 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), respectively (P<0.001). In the ROC curve analysis for the performance of Ki-67 index in the identification of all patients at high risk of recurrence, the accuracy was 65% (P= 0.001; Fig.…”

“…In the EndoPredict cohort, patients were tested between June 2016 and August 2018. This group comprised premenopausal females with HR+ EIBC, HER2 negative, T1-T2, N0-N1 and M0( 21 ). In the MammaPrint cohort, patients were evaluated from June 2016 to August 2018.…”

Correlation between Ki-67 proliferation index in invasive breast cancer and molecular signatures: EndoPredict and MammaPrint

“…The proportion of patients with a high recurrence risk were higher in EndoPredict (56.25% vs 30% p < 0.001). Median Ki-67 proliferation index for the two cohorts in patients with high and low recurrence risk was IQR 30 and 15 [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], respectively (p < 0.001). In the Receiver-operator characteristic (ROC) curve for the performance of Ki-67 expression in the identi cation of patients at high risk of recurrence the accuracy was 65% (p = 0.001), Fig.…”

“…In the EndoPredict (Myriad Genetics, Inc., Salt Lake City, UT, USA) cohort patients were tested between June 2016 to August 2018. This group was comprised of premenopausal women with HR + EIBC, HER2 negative, T1-T2, N0-N1, M0 [21]. In the MammaPrint (Agendia, Inc., Irvine, CA, USA) cohort patients were evaluated from 2011 to 2018.…”