Distribution patterns of 21-gene recurrence score in 980 Chinese estrogen receptor-positive, HER2-negative early breast cancer patients

Wu, Jiayi; Fang, Yan; Lin, Lin; Fei, Xiaochun; Gao, Wang; Zhu, Shu; Zong, Yu; Chen, Xiaosong; Huang, Ou; He, Jianxing; Zhu, Li; Chen, Weiguo; Li, Yafen; Shen, Kunwei

doi:10.18632/oncotarget.16313

Cited by 26 publications

(39 citation statements)

References 25 publications

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“…RS distributed differently according to PR status but the difference did not meet statistical significance, which may be resulted from the insufficient sample size. Moreover, both PR status and Ki-67 index were identified as independent predictors for RS in our previous study in 980 Chinese estrogen receptor-positive, HER2-negative breast cancer patients [15]. Multivariate analyses in our current study showed that molecular subtype defined by Ki-67 and PR level was an independent predictor for RS in both MC and IDC cohorts.…”

Section: Discussionsupporting

confidence: 61%

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Comparison of the Distribution Pattern of 21-Gene Recurrence Score between Mucinous Breast Cancer and Infiltrating Ductal Carcinoma in Chinese Population: A Retrospective Single-Center Study

Ding

Lin

et al. 2020

Cancer Res Treat

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PurposeThis retrospective study aimed to evaluate the distribution pattern and prognostic value of 21-gene recurrence score (RS) in Chinese patients with mucinous breast cancer (MC) and compared with infiltrating ductal carcinoma (IDC).Materials and MethodsPatients diagnosed with MC or IDC from January 2010 to January 2017 were retrospectively recruited. Reverse transcriptase–polymerase chain reaction assay of 21 genes was conducted to calculate the RS. Univariate and multivariate analyses were performed to assess the association between RS and clinicopathological factors. Survival outcomes including disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method and compared by log-rank test.ResultsThe MC cohort included 128 patients and the IDC cohort included 707 patients. The proportions of patients with a low (RS < 18), intermediate (18-30), or high risk (RS > 30) were 32.0%, 48.4%, and 19.5% in MC cohort, and 26.9%, 46.8% and 26.3% in IDC cohort. The distribution of RS varied significantly according to different Ki-67 index and molecular subtype in both cohorts. Moreover, the receipt of chemotherapy was associated with RS in both cohorts. Among patients with MC, tumor stage was related to the DFS (p=0.040). No significant differences in DFS and OS were found among MC patients in different RS risk groups (OS, p=0.695; DFS, p=0.926).ConclusionRS was significantly related to Ki-67 index and molecular subtypes in MC patients, which is similar in IDC patients. However, RS was not able to predict DFS and OS in patients with MC.

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Section: Discussionsupporting

confidence: 61%

“…The methods of sample preparation and RS calculation were similar to that previously described [15,16]. Briefly, hematoxylin and eosin-stained slides were reviewed by pathologists to make sure that the paraffin section used for 21-gene RS analysis contained sufficient tumor tissue.…”

Section: Sample Preparation and Rs Calculationmentioning

confidence: 99%

Comparison of the Distribution Pattern of 21-Gene Recurrence Score between Mucinous Breast Cancer and Infiltrating Ductal Carcinoma in Chinese Population: A Retrospective Single-Center Study

Ding

Lin

et al. 2020

Cancer Res Treat

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“…Histological grade was evaluated according to Elston and Ellis scoring system (24). The pathology and immunohistochemistry (IHC) staining methods used in the present study were previously described (25). Briefly, IHC staining was performed on 4 µm slices of formalin-fixed paraffin-embedded (FFPE) tissue sections.…”

Section: Evaluation Of Er Pr Her2mentioning

confidence: 99%

“…The tests were performed on formalin-fixed, paraffin-embedded tissues, as previously described (10,25). In brief, fixed tissues were incubated for 5-10 h in 10% neutral-buffered formalin prior to being alcohol-dehydrated and embedded in paraffin.…”

Section: -Gene Rs Testingmentioning

confidence: 99%

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21‑gene recurrence score influences the chemotherapy decision for patients with breast cancer of different luminal subtypes

Wang¹,

Lin

Fei

et al. 2019

Oncol Lett

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Luminal subtypes and the 21-gene recurrence score (RS) are important factors in the decision-making process for adjuvant chemotherapy in patients with hormonal receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. However, their effect on adjuvant chemotherapy decisions in the real world has not been thoroughly investigated, particularly for patients of the luminal Alike subtype with a high RS or the luminal B-like subtype with a low RS. The present study, a total of 772 HR + /HER2patients who underwent 21-gene testing, were included in a retrospective analysis. The impact of clinicopathological factors and the 21-gene RS on chemotherapy recommendation was analyzed in the whole population and for patients of different luminal subgroups. The results revealed that chemotherapy was highly recommended for patients of younger age, with larger tumor size, node involvement, higher grade, luminal B-like subtype and higher RS. A high RS was identified to be the most important impact factor for chemotherapy recommendation among all patients [odds ratio (OR), 62.54; 95% CI, 25.58-152.92], the luminal Alike group (OR, 435.05; 95% CI, 29.90-6331.06) and the luminal B-like group (OR, 57.20; 95% CI, 22.42-145.96). For patients of the luminal Alike subtype with a high RS or patients of the luminal B-like subtype with low RS, the 21-gene RS was demonstrated to be the most important independent factor for chemotherapy recommendation, with an adjusted OR of 134.52 (95% CI, 10.39-1741.89). In conclusion, luminal subtypes and the 21-gene RS were found to be associated with chemotherapy recommendation for HR + /HER2patients. For patients with a discordant luminal subtype and 21-gene RS risk, the 21-gene RS score was found to be the most important factor that influences chemotherapy decision, which warrants further clinical evaluation.

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Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients

Pan

Bai

et al. 2021

Breast Cancer Res Treat

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Background Adjuvant therapy decisions may be partly based on the results of a multigene quantitative reverse transcription-polymerase chain reaction (RT-PCR)-based assay: the 21-gene recurrence score (RS) test of resection specimens. When necessary, core needle biopsy (CNB) may be considered as a surrogate. Here, we evaluated the concordance in gene expression according to results from RT-PCR-based RS testing between paired CNBs and resection specimens. Methods CNBs and resection specimens from 50 breast cancer (BC) patients were tested to calculate RSs. First, we examined the concordance of the ER, PR and HER-2 status of tissue samples indicated by immunohistochemical (IHC) and RT-PCR analyses. Then, we compared the IHC findings of ER, PR, HER-2 and Ki-67 staining across paired samples. Ultimately, the RS and single-gene results for ER, PR, HER-2 and Ki-67 were explored between paired samples. Results The concordance between IHC and RT-PCR was 100%, 80.0% and 100% for ER, PR and HER-2, respectively, in both resection specimens and CNBs. The concordance for IHC ER, PR, HER-2 and Ki-67 status was 100%, 94.0%, 52.0% and 82.0%, respectively, between paired samples. RS results from paired samples showed a strong correlation. The overall concordance in RS group classification between samples was 74%, 72% and 78% based on traditional cutoffs, TAILORx cutoffs and ASCO guidelines, respectively. ER, PR, HER-2 and Ki-67 were modestly- to- strongly correlated between paired samples according to the RT-PCR results. Conclusion A modest- to- strong correlation of ER, PR, HER-2 and Ki-67 gene expression and RS between CNBs and resection specimens was observed in the present study. The 21-gene RS test could be reliably performed on CNBs. ER, PR and HER-2 status showed remarkable concordance between the IHC and RT-PCR analyses. The concordance between paired samples was high for the IHC ER, PR and Ki-67 results and low for HER-2.

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Distribution patterns of 21-gene recurrence score in 980 Chinese estrogen receptor-positive, HER2-negative early breast cancer patients

Cited by 26 publications

References 25 publications

Comparison of the Distribution Pattern of 21-Gene Recurrence Score between Mucinous Breast Cancer and Infiltrating Ductal Carcinoma in Chinese Population: A Retrospective Single-Center Study

Comparison of the Distribution Pattern of 21-Gene Recurrence Score between Mucinous Breast Cancer and Infiltrating Ductal Carcinoma in Chinese Population: A Retrospective Single-Center Study

21‑gene recurrence score influences the chemotherapy decision for patients with breast cancer of different luminal subtypes

Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients

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