Publikation

Risk Assessment after Neoadjuvant Chemotherapy in Luminal Breast Cancer Using a Clinicomolecular Predictor

Wissenschaftlicher Artikel/Review - 04.04.2018

Bereiche
PubMed
DOI

Zitation
Loibl S, Kronenwett R, von Minckwitz G, Staebler A, Müller V, Darb-Esfahani S, Hartmann A, Furlanetto J, Kümmel S, Pfitzner B, Engels K, Schem C, Marme F, Krappmann K, Huober J, Weber K, Denkert C. Risk Assessment after Neoadjuvant Chemotherapy in Luminal Breast Cancer Using a Clinicomolecular Predictor. Clin Cancer Res 2018; 24:3358-3365.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Clin Cancer Res 2018; 24
Veröffentlichungsdatum
04.04.2018
eISSN (Online)
1557-3265
Seiten
3358-3365
Kurzbeschreibung/Zielsetzung

This study aimed to evaluate a modified EPclin test (mEPclin), a combination of EndoPredict (EP) score, post-neoadjuvant pathologic tumor size and nodal status, for predicting the risk of distance recurrence after neoadjuvant chemotherapy (NACT) in patients with residual estrogen receptor (ER)-positive/HER2-negative breast cancer. We also compared the prognostic power of the mEPclin with that of the CPS-EG score. A total of 428 formalin-fixed, paraffin-embedded tumor samples from GeparTrio and GeparQuattro studies were evaluated for mRNA expression of eight cancer-related and three reference genes. The mEPclin score was computed using a modified algorithm and predefined cut-off values were used to classify each patient at low or high risk. Primary endpoint was disease-free survival (DFS). A higher continuous mEPclin score was significantly associated with increased risk of relapse [HR, 2.16; 95% confidence interval (CI), 1.86-2.51; < 0.001] and death (HR, 2.28; 95% CI, 1.90-2.75; < 0.001). Similarly, patients classified at high risk by dichotomous mEPclin showed significantly poorer DFS and overall survival compared with those at low risk. In contrast with CPS-EG, the mEPclin remained significantly prognostic for DFS in multivariate analysis (HR, 2.13; 95% CI, 1.73-2.63; < 0.001). Combining CPS-EG and other clinicopathological variables with mEPclin yielded a significant improvement of the prognostic power for DFS versus without mEPclin (c-indices: 0.748 vs. 0.660; < 0.001). The mEPclin score independently predicted the risk of distance recurrence and provided additional prognostic information to the CPS-EG score to assess more accurately the prognosis after NACT in the luminal non-pCR patient population. Therefore, this approach can be used to select patients for additional post-neoadjuvant therapies. .