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Loibl, Sibylle; Weber, Karsten; Huober, Jens; Krappmann, Kristin; Marmé, Frederik; Schem, Christian; Engels, Knut; Pfitzner, Berit Maria; Kümmel, Sherko; Furlanetto, Jenny; Hartmann, Arndt; Darb-Esfahani, Silvia; Müller, Volkmar; Staebler, Annette; von Minckwitz, Gunter; Kronenwett, Ralf; Denkert, Carsten

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

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  • Medientyp: E-Artikel
  • Titel: Risk Assessment after Neoadjuvant Chemotherapy in Luminal Breast Cancer Using a Clinicomolecular Predictor
  • Beteiligte: Loibl, Sibylle; Weber, Karsten; Huober, Jens; Krappmann, Kristin; Marmé, Frederik; Schem, Christian; Engels, Knut; Pfitzner, Berit Maria; Kümmel, Sherko; Furlanetto, Jenny; Hartmann, Arndt; Darb-Esfahani, Silvia; Müller, Volkmar; Staebler, Annette; von Minckwitz, Gunter; Kronenwett, Ralf; Denkert, Carsten
  • Erschienen: American Association for Cancer Research (AACR), 2018
  • Erschienen in: Clinical Cancer Research
  • Sprache: Englisch
  • DOI: 10.1158/1078-0432.ccr-17-2947
  • ISSN: 1078-0432; 1557-3265
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:p>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.</jats:p> <jats:p>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).</jats:p> <jats:p>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 &amp;lt; 0.001] and death (HR, 2.28; 95% CI, 1.90–2.75; P &amp;lt; 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 &amp;lt; 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 &amp;lt; 0.001).</jats:p> <jats:p>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.</jats:p>
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