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

Loibl S, Weber K, Huober J, Krappmann K, Marme F, Schem C, Engels K, Pfitzner BM, Kuemmel S, Furlanetto J, Hartmann A, Darb-Esfahani S, Mueller V, Staebler A, Von Minckwitz G, Kronenwett R, Denkert C (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Clinical Cancer Research American Association for Cancer Research

Book Volume: 24

Pages Range: 3358-3365

Journal Issue: 14

DOI: 10.1158/1078-0432.CCR-17-2947

Abstract

Purpose: 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.Experimental Design: 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).Results: A higher continuous mEPclin score was significantly associated with increased risk of relapse [HR, 2.16; 95% confidence interval (CI), 1.86-2.51; P < 0.001] and death (HR, 2.28; 95% CI, 1.90-2.75; P < 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; P < 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; P < 0.001).Conclusions: 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. Clin Cancer Res; 24(14); 3358-65. ©2018 AACR.

Authors with CRIS profile

Arndt Hartmann Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie

Involved external institutions

GBG Forschungs GmbH (German Breast Group) DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Eberhard Karls Universität Tübingen DE Germany (DE) Sividon Diagnostics GmbH DE Germany (DE) Krankenhaus Jerusalem DE Germany (DE) Kliniken Essen-Mitte DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE)

How to cite

APA:

Loibl, S., Weber, K., Huober, J., Krappmann, K., Marme, F., Schem, C.,... Denkert, C. (2018). Risk Assessment after Neoadjuvant Chemotherapy in Luminal Breast Cancer Using a Clinicomolecular Predictor. Clinical Cancer Research, 24(14), 3358-3365. https://dx.doi.org/10.1158/1078-0432.CCR-17-2947

MLA:

Loibl, Sibylle, et al. "Risk Assessment after Neoadjuvant Chemotherapy in Luminal Breast Cancer Using a Clinicomolecular Predictor." Clinical Cancer Research 24.14 (2018): 3358-3365.

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