Outcomes in patients with early‐stage breast cancer who underwent a 21‐gene expression assay

Abstract

Background Invasive-disease-free survival (IDFS) rates are excellent in breast cancer (BC) patients with hormone-receptor-positive (HR+), human-epidermal-growth-factor-receptor-2-negative (HER2−), axillary-lymph-node-negative (LN−) tumors with a 21-gene-expression assay recurrence-score (RS) of 0–10. However, outcomes among patients with a RS of 11–25 treated with endocrine therapy alone are unknown. Methods In this retrospective single-institution study, we described the characteristics of HR+, HER2−, LN− BC patients who underwent a 21-gene-expression assay. Additionally, among those diagnosed between 2005 and 2011 we measured IDFS, recurrence-free survival (RFS), distant-relapse-free survival (DRFS), and overall survival (OS) rates, focusing on patients with a RS of 11–25 by receipt of chemotherapy. We used the Kaplan-Meier method to estimate survival rates and multivariable Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Among 1,424 patients, the RS distribution was 0–10 in 297 patients (21%), 11–25 in 894 (63%), and >25 in 233 (16%); of these, 1.7%, 15%, and 73.4% received chemotherapy, respectively. With a median follow-up of 58 months, those with a RS of 11–25 had an IDFS rate (95% CI) at 5 years of 92.6% (89.6%–94.7%), which was comparable between those who received chemotherapy and those who did not. The HRs (95% CIs) of the effect of chemotherapy were: IDFS, 1.64 (0.73–3.71); RFS, 1.46 (0.41–5.23); DRFS, 1.25 (0.32–4.92); and OS, 2.19 (0.44–11.0). Conclusion Our study showed similar outcomes with or without chemotherapy in HR+, HER2−, LN− BC patients who have a RS of 11–25, but a benefit from chemotherapy in this group cannot be ruled out.

Ki‑67 index value and progesterone receptor status can predict prognosis and suitable treatment in node‑negative breast cancer patients with estrogen receptor‑positive and HER2‑negative tumors

“…Barcenas et al (12) evaluated the recurrence-free and overall survival rates of patients with an RS of 11-25 after receiving chemotherapy. They found similar results in patients (RS of [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] with or without chemotherapy in HR-positive, HER2-negative, lymph node-negative breast cancer.…”

Automated volumetric radiomic analysis of breast cancer vascularization improves survival prediction in primary breast cancer

“…As every known biomarker thus far has limitations, there is intensive ongoing research into the development of new tissue biomarkers. One of the most promising fields is gene expression profiling of breast cancer 2,3,36,37 . Gene expression profiling is already used in systemic breast cancer treatment planning 3 , and empiric evidence shows that the decision towards more aggressive treatments such as cytotoxic drugs can be based on distinct gene profiles 37 .…”

“…One of the most promising fields is gene expression profiling of breast cancer 2,3,36,37 . Gene expression profiling is already used in systemic breast cancer treatment planning 3 , and empiric evidence shows that the decision towards more aggressive treatments such as cytotoxic drugs can be based on distinct gene profiles 37 . MRI could actually tread the same path: In our analysis, the strength of MRI was a more accurate identification of patients with a less favorable outcome.…”

Tumour-Infiltrating Immune Cell-Based Subtyping and Signature Gene Analysis in Breast Cancer Based on Gene Expression Profiles

“…On the other hand, multiple gene expression signatures of primary breast cancer lesions have been used in clinical practice to predict patient outcomes. Three multigene expression assays (PCR-based OncotypeDX (Genomic Health Inc., Redwood City, CA, USA) [10,11], microarray-based MammaPrint (Agendia Inc., Amsterdam, Netherlands) [12,13], NanoString-based PAM50 Prosigna Assay (NanoString Technologies Inc., Seattle, WA, USA) [14,15]) have been used determine the risk of recurrence in patients with breast cancer. The genes included in these assays mainly played roles in cell proliferation, hormone receptors (HRs) and HER2 related signalling pathways [16].…”