Clinical Utility of Genomic Recurrence Risk Stratification in Early, Hormone-Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer: Real-World Experience.

Autor: Choucair K; Karmanos Cancer Institute, Wayne State University, Detroit, MI., Page SJ; Cancer Center of Kansas, Wichita, KS., Mattar BI; Cancer Center of Kansas, Wichita, KS., Dakhil CS; Cancer Center of Kansas, Wichita, KS., Nabbout NH; Cancer Center of Kansas, Wichita, KS., Deutsch JM; Cancer Center of Kansas, Wichita, KS., Truong QV; Cancer Center of Kansas, Wichita, KS., Truong PV; Cancer Center of Kansas, Wichita, KS., Moore DF Jr; Cancer Center of Kansas, Wichita, KS., Cannon MW; Cancer Center of Kansas, Wichita, KS., Kallail KJ; Kansas University School of Medicine, Wichita, KS., Moore JA; Cancer Center of Kansas, Wichita, KS., Dakhil SR; Cancer Center of Kansas, Wichita, KS., Diab R; Kansas University School of Medicine, Wichita, KS., Kamran S; Kansas University School of Medicine, Wichita, KS., Reddy PS; Cancer Center of Kansas, Wichita, KS; Kansas University School of Medicine, Wichita, KS. Electronic address: pavansreddy@gmail.com.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2023 Feb; Vol. 23 (2), pp. 155-161. Date of Electronic Publication: 2022 Nov 23.
DOI: 10.1016/j.clbc.2022.11.005
Abstrakt: Background: RNA-based genomic risk assessment estimates chemotherapy benefit in patients with hormone-receptor positive (HR+)/Human Epidermal Growth Factor 2-negative (ERBB2-) breast cancer (BC). It is virtually used in all patients with early HR+/ERBB2- BC regardless of clinical recurrence risk.
Patients and Methods: We conducted a retrospective chart review of adult patients with early-stage (T1-3; N0; M0) HR+/ERBB2- BC who underwent genomic testing using the Oncotype DX (Exact Sciences) 21-genes assay. Clinicopathologic features were collected to assess the clinical recurrence risk, in terms of clinical risk score (CRS) and using a composite risk score of distant recurrence Regan Risk Score (RRS). CRS and RRS were compared to the genomic risk of recurrence (GRS).
Results: Between January 2015 and December 2020, 517 patients with early-stage disease underwent genomic testing, and clinical data was available for 501 of them. There was statistically significant concordance between the 3 prognostication methods (P < 0.01). Within patients with low CRS (n = 349), 9.17% had a high GRS, compared to 8.93% in patients with low RRS (n = 280). In patients with grade 1 histology (n = 130), 3.85% had a high GRS and 68.46% had tumors > 1 cm, of whom only 4.49% had a high GRS. Tumor size > 1cm did not associate with a high GRS.
Conclusion: Genomic testing for patients with grade 1 tumors may be safely omitted, irrespective of size. Our finds call for a better understanding of the need for routine genomic testing in patients with low grade/low clinical risk of recurrence.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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