Impact of the 21-Gene Recurrence Score Assay on the Treatment of Estrogen Receptor-Positive, HER2-Negative, Breast Cancer Patients With 1-3 Positive Nodes: A Prospective Clinical Utility Study.

Autor: LeVasseur N; Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, V5Z 4E6, Canada., Sun J; Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, V5Z 4E6, Canada., Fenton D; Vancouver Island Centre, British Columbia, V8R 1J8, Canada., Baxter S; Sindi Ahluwalia Hawkins Centre for the Southern Interior, Kelowna, British Columbia, V1Y 5L3, Canada., Chan A; Fraser Valley Centre, Surrey, British Columbia, V3V 1Z2, Canada., Roberts S; Center for the North, Prince George, British Columbia, V2M 7E9, Canada., Feng X; Vancouver Island Centre, British Columbia, V8R 1J8, Canada., Lohrisch C; Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, V5Z 4E6, Canada., Gelmon K; Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, V5Z 4E6, Canada., Shenkier T; Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, V5Z 4E6, Canada., Chia SK; Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, V5Z 4E6, Canada. Electronic address: schia@bccancer.bc.ca.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2022 Jan; Vol. 22 (1), pp. e74-e79. Date of Electronic Publication: 2021 Sep 17.
DOI: 10.1016/j.clbc.2021.09.004
Abstrakt: Purpose: The use of the 21-gene Recurrence Score (RS) assay is emerging in node-positive estrogen receptor (ER)+ HER2-negative breast cancer (BC), particularly as initial data from the RxPONDER trial are now available. We investigated the impact of the RS result on adjuvant treatment decisions in such patients.
Patients and Methods: This prospective, multi-center study enrolled patients with ER+, HER2-negative BC and 1 to 3 positive nodes (microscopic [N1mi] or macroscopic [N1]). Treating oncologists documented treatment recommendations/plan before and after knowing the RS result. Sample size was determined assuming an overall treatment change rate (from chemohormonal therapy [CHT] to hormone therapy [HT] and vice-versa) of ≥30%.
Results: The study included 84 patients across 5 regional cancer centers, of whom 82 underwent 21-gene testing (77%, N1 disease; 63% grade 2 tumors). Of the RS-tested patients, 60%, 33%, and 7% had RS 0 to 17, 18 to 30, and 31 to 100, respectively. In 43 patients (52%), treatment changed post-RS: 40 patients (49%) from CHT to HT and 3 patients (4%) from HT to CHT. The net change was a 45% reduction in chemotherapy use. Treatment recommendation changes were consistent with the RS result. In RS 0 to 17 patients, the only documented change was from CHT to HT (27 patients). In RS 18-30 patients, change was noted in both directions (CHT-to-HT, 13 patients; HT-to-CHT, 3 patients). No treatment change was reported for the RS 31 to 100 patients, all of whom were recommended CHT pre-testing.
Conclusion: Our results support the clinical utility of the RS assay in ER+ HER2-negative BC with 1 to 3 positive nodes.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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