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The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial.

Fitzal F, Filipits M, Rudas M, Greil R, Dietze O, Samonigg H, Lax S, Herz W, Dubsky P, Bartsch R, Kronenwett R, Gnant M - Br. J. Cancer (2015)

Bottom Line: The risk of LR over a 10-year period among patients with high-risk lesions (n=683) was significantly higher (LRFS=91%) when compared with patients with low-risk lesions (n=641) (10-year LRFS=97.5%) (HR: 1.31 (1.16-1.48) P<0.005).Radiotherapy (RT) after BCT significantly improved LRFS in the cohorts predicted by EP to be low-risk for LR (received RT: n=436, 10-year LRFS 99.8%; did not receive RT: n=63, 10-year LRFS 83.6%, P<0.005).EndoPredict is an effective prognostic tool for predicting LRFS.

View Article: PubMed Central - PubMed

Affiliation: 1] Hospital of the Sisters of Charity, Breast Health Center, Linz, Austria [2] Department of Surgery and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.

ABSTRACT

Background: The aim of this study was to examine whether EndoPredict (EP), a novel genomic expression test, is effective in predicting local recurrence (LR)-free survival (LRFS) following surgery for breast cancer in postmenopausal women. In addition, we examined whether EP may help tailor local therapy in these patients.

Methods: From January 1996 to June 2004, 3714 postmenopausal patients were randomly assigned to either tamoxifen or tamoxifen followed by anastrozole within the prospective ABCSG 8 trial. Using assay scores from EP, we classified breast tumour blocks as either low or high risk for recurrence.

Results: Data were gathered from 1324 patients. The median follow-up was 72.3 months and the cumulative incidence of LR was 2.6% (0.4% per year). The risk of LR over a 10-year period among patients with high-risk lesions (n=683) was significantly higher (LRFS=91%) when compared with patients with low-risk lesions (n=641) (10-year LRFS=97.5%) (HR: 1.31 (1.16-1.48) P<0.005). The groups that received breast conservation surgery (BCT) and mastectomy (MX) had similar LR rates (P=0.879). Radiotherapy (RT) after BCT significantly improved LRFS in the cohorts predicted by EP to be low-risk for LR (received RT: n=436, 10-year LRFS 99.8%; did not receive RT: n=63, 10-year LRFS 83.6%, P<0.005).

Conclusions: EndoPredict is an effective prognostic tool for predicting LRFS. Among postmenopausal, low-risk patients, EP does not appear to be useful for tailoring local therapy.

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Kaplan–Meier curve of LRFS for EP low-risk patients undergoing BCT±RT followed by either adjuvant tamoxifen or a tamoxifen/anastrozole sequence during 5 years. Radiotherapy improved LR even in low-risk patients significantly (P<0.001).
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fig3: Kaplan–Meier curve of LRFS for EP low-risk patients undergoing BCT±RT followed by either adjuvant tamoxifen or a tamoxifen/anastrozole sequence during 5 years. Radiotherapy improved LR even in low-risk patients significantly (P<0.001).

Mentions: RT showed an independent prognostic value for reducing LR (Table 2). The exploratory analyses to determine the effectiveness of RT in the EP low-risk subgroup also demonstrated a significant benefit from RT after BCT (see Figure 3 (P<0.005)). From the 35 events, only 8 took place in the EP low-risk group after BCT (n=499). Local recurrence-free survival in this subgroup was 98.3%. While only one event was found after BCT and RT (n=436; 0.2%), there were seven events observed within the group of patients receiving only BCT (n=63; 11.1%) (see Table 4). The high-risk group had a similar benefit from RT (P<0.005), as demonstrated in Table 4.


The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial.

Fitzal F, Filipits M, Rudas M, Greil R, Dietze O, Samonigg H, Lax S, Herz W, Dubsky P, Bartsch R, Kronenwett R, Gnant M - Br. J. Cancer (2015)

Kaplan–Meier curve of LRFS for EP low-risk patients undergoing BCT±RT followed by either adjuvant tamoxifen or a tamoxifen/anastrozole sequence during 5 years. Radiotherapy improved LR even in low-risk patients significantly (P<0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4402462&req=5

fig3: Kaplan–Meier curve of LRFS for EP low-risk patients undergoing BCT±RT followed by either adjuvant tamoxifen or a tamoxifen/anastrozole sequence during 5 years. Radiotherapy improved LR even in low-risk patients significantly (P<0.001).
Mentions: RT showed an independent prognostic value for reducing LR (Table 2). The exploratory analyses to determine the effectiveness of RT in the EP low-risk subgroup also demonstrated a significant benefit from RT after BCT (see Figure 3 (P<0.005)). From the 35 events, only 8 took place in the EP low-risk group after BCT (n=499). Local recurrence-free survival in this subgroup was 98.3%. While only one event was found after BCT and RT (n=436; 0.2%), there were seven events observed within the group of patients receiving only BCT (n=63; 11.1%) (see Table 4). The high-risk group had a similar benefit from RT (P<0.005), as demonstrated in Table 4.

Bottom Line: The risk of LR over a 10-year period among patients with high-risk lesions (n=683) was significantly higher (LRFS=91%) when compared with patients with low-risk lesions (n=641) (10-year LRFS=97.5%) (HR: 1.31 (1.16-1.48) P<0.005).Radiotherapy (RT) after BCT significantly improved LRFS in the cohorts predicted by EP to be low-risk for LR (received RT: n=436, 10-year LRFS 99.8%; did not receive RT: n=63, 10-year LRFS 83.6%, P<0.005).EndoPredict is an effective prognostic tool for predicting LRFS.

View Article: PubMed Central - PubMed

Affiliation: 1] Hospital of the Sisters of Charity, Breast Health Center, Linz, Austria [2] Department of Surgery and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.

ABSTRACT

Background: The aim of this study was to examine whether EndoPredict (EP), a novel genomic expression test, is effective in predicting local recurrence (LR)-free survival (LRFS) following surgery for breast cancer in postmenopausal women. In addition, we examined whether EP may help tailor local therapy in these patients.

Methods: From January 1996 to June 2004, 3714 postmenopausal patients were randomly assigned to either tamoxifen or tamoxifen followed by anastrozole within the prospective ABCSG 8 trial. Using assay scores from EP, we classified breast tumour blocks as either low or high risk for recurrence.

Results: Data were gathered from 1324 patients. The median follow-up was 72.3 months and the cumulative incidence of LR was 2.6% (0.4% per year). The risk of LR over a 10-year period among patients with high-risk lesions (n=683) was significantly higher (LRFS=91%) when compared with patients with low-risk lesions (n=641) (10-year LRFS=97.5%) (HR: 1.31 (1.16-1.48) P<0.005). The groups that received breast conservation surgery (BCT) and mastectomy (MX) had similar LR rates (P=0.879). Radiotherapy (RT) after BCT significantly improved LRFS in the cohorts predicted by EP to be low-risk for LR (received RT: n=436, 10-year LRFS 99.8%; did not receive RT: n=63, 10-year LRFS 83.6%, P<0.005).

Conclusions: EndoPredict is an effective prognostic tool for predicting LRFS. Among postmenopausal, low-risk patients, EP does not appear to be useful for tailoring local therapy.

Show MeSH
Related in: MedlinePlus