A Biological Signature for Breast Ductal Carcinoma In Situ to Predict Radiotherapy Benefit and Assess Recurrence Risk.

Autor:	Bremer T; PreludeDx, Laguna Hills, California. tbremer@preludedx.com Fredrik.Warnberg@surgsci.uu.se., Whitworth PW; Nashville Breast Center, Nashville, Tennessee., Patel R; Good Samaritan Cancer Center, Los Gatos, California., Savala J; PreludeDx, Laguna Hills, California., Barry T; Spectrum Pathology, Inc., Mission Viejo, California., Lyle S; University of Massachusetts Medical School, Worcester, Massachusetts., Leesman G; PreludeDx, Laguna Hills, California., Linke SP; Steven P. Linke Consulting, Carlsbad, California., Jirström K; Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden., Zhou W; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden., Amini RM; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden., Wärnberg F; Department of Surgical Sciences, Uppsala University, Department of Surgery, Uppsala Academic Hospital, Uppsala, Sweden. tbremer@preludedx.com Fredrik.Warnberg@surgsci.uu.se.
Jazyk:	angličtina
Zdroj:	Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2018 Dec 01; Vol. 24 (23), pp. 5895-5901. Date of Electronic Publication: 2018 Jul 27.
DOI:	10.1158/1078-0432.CCR-18-0842
Abstrakt:	Purpose: Ductal carcinoma in situ (DCIS) patients and their physicians currently face challenging treatment decisions with limited information about the individual's subsequent breast cancer risk or treatment benefit. The DCISionRT biological signature developed in this study provides recurrence risk and predicts radiotherapy (RT) benefit for DCIS patients following breast-conserving surgery (BCS). Experimental Design: A biological signature that calculates an individualized Decision Score (DS) was developed and cross-validated in 526 DCIS patients treated with BCS ± RT. The relationship was assessed between DS and 10-year risk of invasive breast cancer (IBC) or any ipsilateral breast event (IBE), including IBC or DCIS. RT benefit was evaluated by risk group and as a function of DS. Results: The DS was significantly associated with IBC and IBE risk, HR (per 5 units) of 4.2 and 3.1, respectively. For patients treated without RT, DS identified a Low Group with 10-year IBC risk of 4% (7% IBE) and an Elevated Risk Group with IBC risk of 15% (23% IBE). In analysis of DS and RT by group, the Elevated Risk Group received significant RT benefit, HR of 0.3 for IBC and IBE. In a clinicopathologically low-risk subset, DS reclassified 42% of patients into the Elevated Risk Group. In an interaction analysis of DS and RT, patients with elevated DS had significant RT benefit over baseline. Conclusions: The DS was prognostic for risk and predicted RT benefit for DCIS patients. DS identified a clinically meaningful low-risk group and a group with elevated 10-year risks that received substantial RT benefit over baseline. (©2018 American Association for Cancer Research.)
Databáze:	MEDLINE
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