The Role of Oncotype DX® Recurrence Score in Predicting Axillary Response After Neoadjuvant Chemotherapy in Breast Cancer
Autor: | Stephanie K. Serres, Monica G. Valero, Betty Fan, Isha Emhoff, Amulya Alapati, Alessandra Mele, Ted A. James, Jaime A. Pardo |
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Rok vydání: | 2021 |
Předmět: |
Oncology
medicine.medical_specialty Chemotherapy medicine.diagnostic_test business.industry medicine.medical_treatment Recurrence score Predictive capability medicine.disease 03 medical and health sciences 0302 clinical medicine Breast cancer Surgical oncology 030220 oncology & carcinogenesis Predictive value of tests Internal medicine medicine 030211 gastroenterology & hepatology Surgery business Oncotype DX Neoadjuvant therapy |
Zdroj: | Annals of Surgical Oncology. 28:1320-1325 |
ISSN: | 1534-4681 1068-9265 |
Popis: | Oncotype DX® recurrence score (RS) is well-recognized for guiding decision making in adjuvant chemotherapy; however, the predictive capability of this genomic assay in determining axillary response to neoadjuvant chemotherapy (NCT) has not been established. Using the National Cancer Data Base (NCDB), we identified patients diagnosed with T1-T2, clinically N1/N2, estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER +/HER2 −) invasive ductal carcinoma of the breast between 2010 and 2015. Patients with an Oncotype DX® RS who received NCT were included. RS was defined as low ( 30). Unadjusted and adjusted analyses were performed to determine the association between axillary pathologic complete response (pCR) and RS. This study included a total of 158 women. RS was low in 56 (35.4%) patients, intermediate in 62 (39.2%) patients, and high in 40 (25.3%) patients. The majority of patients presented with clinical N1 disease (89.2%). Axillary pCR was achieved in 23 (14.6%) patients. When stratifying patients with axillary pCR by RS, 11 (47.8%) patients had a high RS, 6 (26.1%) patients had an intermediate RS, and 6 (26.1%) patients had a low RS. Comparing cohorts by RS, 27.5% of patients with high RS tumors had an axillary pCR, compared with only 9.7% in the intermediate RS group, and 10.7% in the low RS group (p = 0.0268). Our findings demonstrate that Oncotype DX® RS is an independent predictor of axillary pCR in patients with ER +/HER2 − breast cancers receiving NCT. A greater proportion of patients with a high RS achieved axillary pCR. These results support Oncotype DX® as a tool to improve clinical decision making in axillary management. |
Databáze: | OpenAIRE |
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