Utility of the CPS+EG staging system in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer treated with neoadjuvant chemotherapy

Publication

Utility of the CPS+EG staging system in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer treated with neoadjuvant chemotherapy

Journal Paper/Review - Dec 13, 2015

Marme Frederik, von Minckwitz Gunter, Untch Michael, Paepke Stefan, Loibl Sibylle, Kümmel Sherko, Jackisch Christian, Huober Jens, Hilfrich Jörn, Hanusch Claus, Gerber Bernd, Eidtmann Holger, Denkert Carsten, Costa Serban Dan, Blohmer Jens-Uwe, Lederer Bianca, Schneeweiss Andreas

Citation

Marme F, von Minckwitz G, Untch M, Paepke S, Loibl S, Kümmel S, Jackisch C, Huober J, Hilfrich J, Hanusch C, Gerber B, Eidtmann H, Denkert C, Costa S, Blohmer J, Lederer B, Schneeweiss A. Utility of the CPS+EG staging system in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer treated with neoadjuvant chemotherapy. Eur J Cancer 2015; 53:65-74.

Type

Journal Paper/Review (English)

Journal

Eur J Cancer 2015; 53

Publication Date

Dec 13, 2015

Issn Electronic

1879-0852

Pages

65-74

Brief description/objective

BACKGROUND
Pathologic complete response after neoadjuvant chemotherapy (NACT) correlates with overall survival (OS) in primary breast cancer. A recently described staging system based on pre-treatment clinical stage (CS), final pathological stage (PS), estrogen receptor (ER) status and nuclear grade (NG) leads to a refined estimation of prognosis in unselected patients. Its performance in luminal type breast cancers has not been determined. This study investigates the clinical utility of this CPS+EG score when restricted to hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) patients and compares the results to a cohort of unselected patients.

METHODS
The CPS+EG score was calculated for 6637 unselected patients and 2454 patients with HR+/HER2- tumours who received anthracycline/taxane-based NACT within 8 prospective German trials.

RESULTS
Five-year disease-free survival (DFS) and OS were 75.6% and 84.1% for the unselected cohort and 80.6% and 87.8% for the HR+/HER2- subgroup, respectively. The CPS+EG system distinguished different prognostic groups with 5-year DFS ranging from 0% to 91%. The CPS+EG system leads to an improved categorisation of patients by outcome compared to CS, PS, ER or NG alone. When applying the CPS+EG score to the HR+/HER2- subgroup, a shift to lower scores was observed compared to the overall population, but 5-year DFS and OS for the individual scores were identical to that observed in the overall population.

CONCLUSIONS
In HR+/HER2- patients, the CPS+EG staging system retains its ability to facilitate a refined stratification of patients according to outcome. It can help to select candidates for post-neoadjuvant clinical trials in luminal breast cancer.