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Prediction of chemotherapy benefit by EndoPredict in patients with breast cancer who received adjuvant endocrine therapy plus chemotherapy or endocrine therapy alone.
Breast Cancer Research and Treatment ( IF 3.8 ) Pub Date : 2019-05-02 , DOI: 10.1007/s10549-019-05226-8
Ivana Sestak 1 , Miguel Martín 2, 3 , Peter Dubsky 4, 5 , Ralf Kronenwett 6 , Federico Rojo 3, 7 , Jack Cuzick 1 , Martin Filipits 5, 8 , Amparo Ruiz 3, 9 , William Gradishar 10 , Hatem Soliman 11 , Lee Schwartzberg 12 , Richard Buus 13, 14 , Dominik Hlauschek 8 , Alvaro Rodríguez-Lescure 3, 15 , Michael Gnant 5, 7
Affiliation  

PURPOSE EndoPredict (EPclin) is a prognostic test validated to inform decisions on adjuvant chemotherapy to endocrine therapy alone for patients with oestrogen receptor-positive, HER2-negative breast cancer. Here, we determine the performance of EPclin for estimating 10-year distant recurrence-free interval (DRFI) rates for those who received adjuvant endocrine therapy (ET) alone compared to those with chemotherapy plus endocrine therapy (ET + C). METHODS A total of 3746 women were included in this joint analysis. 2630 patients received 5 years of ET alone (ABCSG-6/8, TransATAC) and 1116 patients received ET + C (GEICAM 2003-02/9906). The primary objective was to evaluate the ability of EPclin to provide an estimate of the 10-year DR rate as a continuous function of EPclin separately for ET alone and ET + C. Cox proportional hazard models were used for these analyses. RESULTS EPclin was highly prognostic for DR in women who received ET alone (HR 2.79 (2.49-3.13), P < 0.0001) as well as in those who received ET + C (HR 2.27 (1.99-2.59), P < 0.0001). Women who received ET + C had significantly smaller increases in 10-year DR rates with the increasing EPclin score than those receiving ET alone (EPclin = 5; 12% ET + C vs. 20% ET alone). We observed a significant positive interaction between EPclin and treatment groups (P-interaction = 0.022). CONCLUSIONS In this comparative non-randomised analysis, the rate of increase in DR with EPclin score was significantly reduced in women who received ET + C versus ET alone. Our indirect comparisons suggest that a high EPclin score can predict chemotherapy benefit in women with ER-positive, HER2-negative disease.

中文翻译:

EndoPredict对接受辅助内分泌治疗加化学疗法或仅内分泌治疗的乳腺癌患者的化疗益处进行预测。

目的EndoPredict(EPclin)是一种预后测试,经验证可为患有雌激素受体阳性,HER2阴性的乳腺癌患者单独行内分泌治疗辅助化疗提供依据。在这里,我们确定了单独使用辅助内分泌治疗(ET)的患者与化疗加内分泌治疗(ET + C)的患者相比,EPclin评估10年远距离无复发间隔(DRFI)率的性能。方法该研究共纳入3746名女性。2630例患者接受了5年的ET单独治疗(ABCSG-6 / 8,TransATAC),而1116例患者接受了ET + C治疗(GEICAM 2003-02 / 9906)。主要目的是评估EPclin对单独的ET和ET + C分别提供10年DR率作为EPclin连续功能的估计的能力。这些分析使用Cox比例风险模型。结果EPclin在单独接受ET的女性(HR 2.79(2.49-3.13),P <0.0001)以及接受ET + C的女性(HR 2.27(1.99-2.59),P <0.0001)中对DR的预后较高。与单独接受ET的女性相比,接受ET + C的女性在10年DR率上随着EPclin分数的增加而增加的幅度明显较小(EPclin = 5; ET + C为12%,而单独接受ET的女性为20%)。我们观察到EPclin与治疗组之间存在显着的正相互作用(P相互作用= 0.022)。结论在该比较性非随机分析中,与单独使用ET相比,接受ET + C的女性DR随EPclin评分的增加率显着降低。我们的间接比较结果表明,EPclin得分高可以预测ER阳性,
更新日期:2019-11-01
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