New Strategies in Breast Cancer: The Significance of Molecular Subtypes in Systemic Adjuvant Treatment for Small T1a,bN0M0 Tumors

Sonnenblick, Amir; Fumagalli, Debora; Azim, Hatem A.; Sotiriou, Christos; Piccart, Martine

doi:10.1158/1078-0432.ccr-14-1086

Cited by 17 publications

(5 citation statements)

References 48 publications

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“…Much attention has been paid to small sized tumors in recent years, because T1a,bN0 tumors generally present with a good prognosis. Information from large population databases of untreated T1a,bN0M0 patients demonstrated relatively low cancer‐related mortality rates at 15 years (< 10%) . Vaz‐Luis et al examined data of 4113 women with T1a,bN0M0 BC between 2000 and 2009 from the National Comprehensive Cancer Network Database .…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features and survival of early stage breast cancer in northwest China: A population‐based retrospective study of 1287 patients

Wang

Jiao

et al. 2017

Thoracic Cancer

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BackgroundBreast cancer (BC) displays different clinicopathological features and outcomes based on patient age, molecular subtype, and treatment. However, such features in BC patients in northwest China are unclear. This study investigated the clinicopathological features and overall survival (OS) of early stage BC patients using a population‐based study.MethodsPatients who were newly diagnosed with BC at the First Affiliated Hospital of Xi'an Jiaotong University between January 2001 and June 2012 were included. Clinicopathological features and OS were assessed.ResultsThe median age of 1287 patients was 50 years, with an average tumor size of 2.65 cm. Additionally, 42.7% were luminal A, 25.6% luminal B, 9.3% Her2 overexpression, and 17.7% triple negative. The cut‐off age was 35 years, and young patients (< 35) tended to have larger tumors, ≥ 4 positive lymph nodes, grade 2 or 3 histology, non‐luminal types, high Ki67, and poor outcomes. Patients with luminal A tumors showed moderate features: 50.6% had tumors < 2 cm, 56.7% had negative lymph nodes. Patients with Her2 overexpression tumors showed aggressive features and the poorest survival (5‐year OS 67.6%). Patients with triple negative tumors were the youngest (average 48.4 years), but had the largest proportion of grade 3 histology and poor outcomes.ConclusionOur results are consistent with those in other provinces in China, but showed an earlier age at diagnosis and more aggressive pathological features compared to developed countries. Additionally, each molecular subtype showed specific features and different survival outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological features and survival of early stage breast cancer in northwest China: A population‐based retrospective study of 1287 patients

Wang

Jiao

et al. 2017

Thoracic Cancer

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“…Assessing the respective marker expression allows an assignment to one of four subgroups Her2 positive , Luminal A , Luminal B and Triple Negative initially defined by gene expression profiling [13] , [14] . The subtypes have got a distinct prognosis and are differentially treated [15] .…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Molecular Breast Cancer Subtypes based on Her2, ESR1, PGR and Ki67 mRNA-Expression in Muscle Invasive Bladder Cancer

Kriegmair

Wirtz²,

Worst

et al. 2018

Translational Oncology

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INTRODUCTION: Gene expression analyses have identified similarities between bladder and breast cancer, where clinical risk stratification is based on Her2, ESR1, PGR and Ki67 expression. The aim of the study was to assess the respective marker gene expression in patients treated with radical cystectomy for muscle-invasive bladder cancer (MIBC) and to evaluate the applicability of breast cancer subtypes for MIBC risk stratification. MATERIALS & METHODS: 102 patients treated with radical cystectomy for MIBC were assessed. Using routine FFPE tissue and an IVD validated kit, mRNA expression was measured by single step RT-qPCR. Partition test were employed to define cut-off values for high or low marker gene expression. Association of expression with outcome was assessed using Kaplan-Meier analysis and multivariate cox regression analysis. Finally, we performed validation of our results in the MD-Anderson cohort (n = 57). RESULTS: Cancer specific survival (CSS) was impaired in patients with high gene expression of Her2 (P = 0.0009) and ESR1 (P = 0.04). In the multivariate regression model Her2 expression remained significant for the prediction of CSS (HR = 2.11, CI 1.11-4.21, P = 0.024). Furthermore, molecular stratification by breast cancer subgroups was significant (P = 0.023) for CSS prediction. Especially the differentiation between Her2-positive and Luminal A (HR = 4.41, CI 1.53-18.71, P = 0.004) and Luminal B (HR = 1.96, CI 0.99-4.08, P = 0.053) respectively was an independent prognostic parameter for CSS. External validation resulted in comparable risk stratification with differences in fractional subgroups distribution. CONCLUSION: Gene expression of Her2, ESR1, PGR, Ki67 and corresponding breast cancer subtypes allow a risk-stratification in MIBC, whereby Her2 overexpressing tumors reveal a particularly poor prognosis.

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“…Previous retrospective studies have demonstrated the survival benefits of adjuvant chemotherapy for patients with T1cN0M0 TNBC [42][43][44]. We incorporated tumor grade, which is an independent prognostic indicator, to assess the effects of adjuvant chemotherapy [45][46][47]. Patients, including those with TNBC, can be exempt from adjuvant chemotherapy if they have grade I/II T1bN0M0 and grade I T1cN0M0 BC [48].…”

Section: Discussionmentioning

confidence: 99%

Impact of adjuvant chemotherapy on T1N0M0 breast cancer patients: a propensity score matching study based on SEER database and external cohort

Shen

et al. 2022

BMC Cancer

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Background There is no clear consensus on the benefits of adjuvant chemotherapy for tumor-node-metastasis (TNM) stage T1 (T1N0M0) breast cancer (BC). Our study investigated the effects of adjuvant chemotherapy on T1N0M0 BC patients. Methods Seventy-five thousand one hundred thirty-nine patients diagnosed with T1N0M0 BC were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox analyses were performed to investigate the effects of adjuvant chemotherapy on T1a, T1b, and T1cN0M0 BC, including various tumor grades, and four molecular subtypes. Propensity score matching (PSM) was used to eliminate confounding factors and further compare the results between adjuvant chemotherapy and no adjuvant chemotherapy. Additionally, 545 T1N0M0 BC patients treated at the Northern Jiangsu People’s Hospital were included as an independent external validation cohort. Univariate and multivariate Cox analyses were used to confirm the effects of adjuvant chemotherapy in T1a, T1b, and T1cN0M0 BC. Survival curves for the different tumor grades and molecular subtypes were plotted using the Kaplan–Meier method. Results Adjuvant chemotherapy demonstrated a statistically significant improvement in overall survival (OS) in T1b and T1c BC, but not in T1a BC. Within T1b BC, adjuvant chemotherapy was found to have effects on grade III, and hormone receptor + (HoR +)/human epidermal growth factor receptor 2 + (HER2 +), HoR-/HER2 + , and HoR-/HER2- molecular subtypes, respectively. Adjuvant chemotherapy was beneficial to OS for grade II/III and T1c BC. Identical results were obtained after PSM. We also obtained similar results with external validation cohort, except that adjuvant chemotherapy made a difference in grade II and T1b BC of the external validation dataset. Conclusions Partial T1N0M0 BC patients with grade III T1bN0M0, patients with tumor grade II and III T1cN0M0, and excluding those with HoR + /HER2- subtype tumors, could obtain OS benefits from adjuvant chemotherapy.

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New Strategies in Breast Cancer: The Significance of Molecular Subtypes in Systemic Adjuvant Treatment for Small T1a,bN0M0 Tumors

Cited by 17 publications

References 48 publications

Clinicopathological features and survival of early stage breast cancer in northwest China: A population‐based retrospective study of 1287 patients

Clinicopathological features and survival of early stage breast cancer in northwest China: A population‐based retrospective study of 1287 patients

Prognostic Value of Molecular Breast Cancer Subtypes based on Her2, ESR1, PGR and Ki67 mRNA-Expression in Muscle Invasive Bladder Cancer

Impact of adjuvant chemotherapy on T1N0M0 breast cancer patients: a propensity score matching study based on SEER database and external cohort

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