Comparison of StemPrintER with Oncotype DX Recurrence Score for predicting risk of breast cancer distant recurrence after endocrine therapy.

Abstract

OBJECTIVE:

Molecular tests predicting the risk of distant recurrence (DR) can be used to assist therapy decision-making in oestrogen receptor-positive (ER+) and human epidermal growth factor receptor 2-negative (HER2-) breast cancer patients after considerations of standard clinical markers. The Oncotype DX Recurrence Score (RS) is a widespread tool used for this purpose. Here, we compared the RS with the StemPrintER Risk Score (SPRS), a novel genomic predictor with a unique biological basis in its ability to measure the expression of cancer stemness genes.

MATERIALS AND METHODS:

We benchmarked the SPRS vs. RS, alone or in combination with clinicopathological variables expressed by the Clinical Treatment Score (CTS), for the prognostication of DR in a retrospective cohort of 776 postmenopausal patients with ER+/HER2-breast cancer enrolled in the translational arm of the randomised Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial. Likelihood ratio (LR) with χ2 test and C-index were used to assess prognostic performance for the entire ten-year follow-up period and in early (0-5 years) and late (5-10 years) intervals.

RESULTS:

In all patients, the SPRS provided significantly more prognostic information than the RS for ten-year DR prognostication (C-index = 0.688, LR-χ2 = 33.4 vs. C-index = 0.641, LR-χ2 = 22.1) and for late (5-10 years) DR prognostication (C-index = 0.689, LR-χ2 = 18.8 vs. C-index = 0.571, LR-χ2 = 4.7). The SPRS also provided more prognostic information than the RS when added to the CTS in all patients (CTS + SPRS: LR-Δχ2 = 14.9; CTS + RS: LR-Δχ2 = 9.7) and in node-negative patients (CTS + SPRS: LR-Δχ2 = 11.7; CTS + RS: LR-Δχ2 = 6.6).

CONCLUSIONS:

In postmenopausal ER+/HER2- breast cancer patients, SPRS provided more prognostic information than RS for DR when used alone or in combination with the CTS. The SPRS could therefore potentially identify high-risk patients, who might benefit from aggressive treatments, from low-risk patients who might safely avoid adjuvant chemotherapy or prolongation of endocrine therapy.

• Authors: Salvatore Pece, Ivana Sestak, Francesca Montani, Micol Tillhon, Patrick Maisonneuve, Stefano Freddi, Kim Chu, Marco Colleoni, Paolo Veronesi, Davide Disalvatore, Giuseppe Viale, Richard Buus, Jack Cuzick, Mitch Dowsett, Pier Paolo Di Fiore
• Journal: European journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 164 Pg. 52-61 (03 2022) ISSN: 1879-0852 [Electronic] England
• PMID: 35172273 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Biomarkers, Tumor
• Tamoxifen
• Anastrozole
• Receptor, ErbB-2

Topics

• Anastrozole (therapeutic use)
• Biomarkers, Tumor (genetics)
• Breast Neoplasms (drug therapy, genetics, pathology)
• Female
• Humans
• Neoplasm Recurrence, Local (pathology)
• Prognosis
• Receptor, ErbB-2 (genetics, metabolism)
• Retrospective Studies
• Tamoxifen (therapeutic use)