Prognostic Value of EndoPredict in Women with Hormone Receptor-Positive, HER2-Negative Invasive Lobular Breast Cancer.

Abstract

PURPOSE:

Invasive lobular carcinoma (ILC) accounts for approximately 5%-15% of all invasive breast cancer cases. Most of the correlations between multigene assays and patient outcome were derived from studies based on patients with invasive ductal carcinoma (IDC) or without distinction between the subtypes. Here, we investigate the prognostic value of EndoPredict (EPclin) in a large cohort of ILCs pooled from three phase III randomized trials (ABCSG-6, ABCSG-8, TransATAC).

EXPERIMENTAL DESIGN:

The primary objective of this analysis was to determine the prognostic value of EPclin for distant recurrence (DR) in years 0-10 in postmenopausal women with ILC. The primary outcome was DR.

RESULTS:

470 women (17.9%) presented with ILC, 1,944 (73.9%) with IDC, and 216 (8.2%) with other histologic types. EPclin was highly prognostic in women with ILC [HR = 3.32 (2.54-4.34)] and provided more prognostic value than the Clinical Treatment Score [CTS; HR = 2.17 (1.73-2.72)]. 63.4% of women were categorized into the low EPclin risk group and they had a 10-year DR of 4.8% (2.7-8.4) compared with 36.6% of women in the high-risk group with a 10-year DR risk of 26.6% (20.0-35.0). EPclin also provided highly prognostic information in women with node-negative disease [HR = 2.56 (1.63-4.02)] and node-positive disease [HR = 3.70 (2.49-5.50)].

CONCLUSIONS:

EPclin provided highly significant prognostic value and significant risk stratification for women with ILC. Ten-year DR risk in the EPclin low-risk groups were similar between ILC and IDC. Our results show that EPclin is informative in women with ILC and suggest that it is equally valid in both histologic subtypes.

• Authors: Ivana Sestak, Martin Filipits, Richard Buus, Margaretha Rudas, Marija Balic, Michael Knauer, Ralf Kronenwett, Florian Fitzal, Jack Cuzick, Michael Gnant, Richard Greil, Mitch Dowsett, Peter Dubsky
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 26 Issue 17 Pg. 4682-4687 (09 01 2020) ISSN: 1557-3265 [Electronic] United States
• PMID: 32561662 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: ©2020 American Association for Cancer Research.

Chemical References

• Antineoplastic Agents, Hormonal
• Receptors, Estrogen
• Receptors, Progesterone
• ERBB2 protein, human
• Receptor, ErbB-2

Topics

• Aged
• Antineoplastic Agents, Hormonal (therapeutic use)
• Breast (pathology, surgery)
• Breast Neoplasms (genetics, mortality, pathology, therapy)
• Carcinoma, Lobular (genetics, mortality, pathology, therapy)
• Chemotherapy, Adjuvant (methods)
• Clinical Trials, Phase III as Topic
• Datasets as Topic
• Disease-Free Survival
• Female
• Follow-Up Studies
• Gene Expression Profiling
• Humans
• Kaplan-Meier Estimate
• Mastectomy
• Middle Aged
• Neoplasm Recurrence, Local (epidemiology, genetics, pathology)
• Prognosis
• Randomized Controlled Trials as Topic
• Receptor, ErbB-2 (analysis, metabolism)
• Receptors, Estrogen (analysis, metabolism)
• Receptors, Progesterone (analysis, metabolism)
• Risk Assessment (methods)