Nomogram update based on TAILORx clinical trial results - Oncotype DX breast cancer recurrence score can be predicted using clinicopathologic data
| Autor: | John L. Bell, Alison P. McNabb, Amila Orucevic, Robert E. Heidel, Megan King |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Databases Factual Breast Neoplasms Logistic regression Risk Assessment 03 medical and health sciences 0302 clinical medicine Breast cancer Predictive Value of Tests Internal medicine Biomarkers Tumor Humans Medicine 030212 general & internal medicine Aged Clinical Trials as Topic Receiver operating characteristic medicine.diagnostic_test business.industry General Medicine Middle Aged Nomogram Prognosis medicine.disease Clinical trial Nomograms ROC Curve 030220 oncology & carcinogenesis Cohort Hormonal therapy Female Surgery Neoplasm Recurrence Local business Oncotype DX |
| Zdroj: | The Breast. 46:116-125 |
| ISSN: | 0960-9776 |
| DOI: | 10.1016/j.breast.2019.05.006 |
| Popis: | Objectives Oncotype DX (ODX), 21-gene breast cancer (BC) assay, predicts risk of recurrence and benefits of addition of chemotherapy to hormonal therapy for early-stage BC. We previously published a nomogram/calculator that could predict ODX results without performing the test by using clinicopathologic characteristics of BC available from pathology reports. Patients with intermediate-risk (11–25) ODXRS (RS) were excluded from that nomogram. This update tests the predictive value of clinicopathologic variables for forecasting the ODXRS while including intermediate-risk-ODXRS patients and stratifying ODXRS based on recently published TAILORx clinical trial results (0–25 = low-risk, 26–100 = high-risk-ODXRS; intermediate-risk-ODXRS belongs to the low-risk category). Material and methods The nomogram was built on 65,754 ODX-tested ER+/HER2-/lymph-node-negative patients with 6–50 mm tumor, captured by the National Cancer Data Base (NCDB) from 2010 to 2014. Five clinicopathologic variables (age, tumor size, grade, progesterone-receptor status (PR) and BC-histologic type) were assessed with logistic regression to predict for a low-risk (0–25) or a high-risk (26–100) ODXRS. Results were validated on a separate 18,585 ODX-tested cohort from 2015. Results Grade and PR were the highest significant predictors of both low-risk and high-risk-ODXRS, followed by histologic type, tumor size and age. The Receiver Operator Characteristic (ROC) curve showed strong statistical model for both low-risk and high-risk-ODXRS prediction outcomes (c-index = 0.81). Conclusions An updated nomogram is now developed/validated on the entire population of ODX-tested patients (84,339) captured by the NCDB. The nomogram/calculator, available on-line at the UTMCK/Shiny website ( https://utgsm.shinyapps.io/OncotypeDXCalculator/ ), will continue serving as a surrogate for BC patients for which ODX testing is not affordable, available or necessary. |
| Databáze: | OpenAIRE |
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