Response to neoadjuvant chemotherapy and the 21-gene Breast Recurrence Score test in young women with estrogen receptor-positive early breast cancer

被引:14
|
作者
Sella, Tal [1 ,2 ]
Gelber, Shari, I [1 ]
Poorvu, Philip D. [1 ,2 ,3 ]
Kim, Hee-Jeong [4 ]
Dominici, Laura [1 ,2 ,5 ]
Guzman-Arocho, Yaileen D. [2 ,6 ]
Collins, Laura [2 ,6 ]
Ruddy, Kathryn J. [7 ]
Tamimi, Rulla M. [3 ,8 ]
Peppercorn, Jeffrey M. [2 ,9 ]
Schapira, Lidia [10 ]
Borges, Virginia F. [11 ]
Come, Steven E. [2 ,6 ]
Warner, Ellen [12 ]
Snow, Craig [1 ]
Jakubowski, Debbie M. [13 ]
Russell, Christy A. [13 ]
Winer, Eric P. [1 ,2 ,3 ]
Rosenberg, Shoshana M. [1 ,2 ]
Partridge, Ann H. [1 ,2 ,3 ]
机构
[1] Dana Farber Canc Inst, 450 Brookline Ave, Boston, MA 02215 USA
[2] Harvard Med Sch, Boston, MA 02115 USA
[3] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA
[4] Asan Med Ctr, Seoul, South Korea
[5] Brigham & Womens Hosp, Dept Surg, Div Breast Surg, 75 Francis St, Boston, MA 02115 USA
[6] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
[7] Mayo Clin, Dept Oncol, Rochester, MN USA
[8] Weill Cornell Med, Dept Populat Hlth Sci, New York, NY USA
[9] Massachusetts Gen Hosp, Boston, MA 02114 USA
[10] Stanford Canc Inst, Palo Alto, CA USA
[11] Univ Colorado, Comprehens Canc Ctr, Aurora, CO USA
[12] Sunnybrook Hlth Sci Ctr, Odette Canc Ctr, Toronto, ON, Canada
[13] Genom Hlth, Redwood City, CA USA
关键词
Neoadjuvant chemotherapy; Pathological complete response; 21-gene Breast Recurrence Score; Young women; GENE-EXPRESSION; THERAPY; BIOPSIES; ASSAY;
D O I
10.1007/s10549-020-05989-5
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose The 21-gene Breast Recurrence Score test predicts benefit from adjuvant chemotherapy in estrogen receptor-positive, HER2-negative (ER+/HER2-) breast cancer (BC). We examined whether the 21-gene assay predicts response to neoadjuvant chemotherapy (NCT). Methods We identified patients with stage I-III ER+/HER2- BC treated with NCT from the Young Women's Breast Cancer Study, a prospective cohort of women diagnosed with BC at age <= 40 years. The 21-gene assay was performed on tumor specimens removed prior to NCT either as part of clinical care or retrospectively for research. Pathological complete response (pCR) was defined as ypT0/is ypN0. The relationship between Recurrence Score result and pCR was evaluated using logistic regression modeling. Results 76 women received NCT for ER+/HER2- BC and were eligible for this analysis. Median age at diagnosis was 37 years (range 24-40). Scores ranged between 5 and 77 with 50% >25 and 5% <11. Median Recurrence Score result was significantly higher among tumors achieving pCR vs. non-pCR response (61.5 vs. 23, p(wilcoxon) = 0.0005). pCR rate in patients with scores >25 was 21% (8/38) vs. 5% in patients with scores 25 (2/38) (p = 0.09), with both pCRs in the 25 group in patients with scores between 21 and 25. In multivariable analysis, only Recurrence Score result was significantly associated with pCR (OR: 1.07, 95%CI 1.01-1.12, p = 0.01). Conclusions In young women with ER+/HER2- BC who received NCT, higher pretreatment Recurrence Score result was associated with an increased likelihood of pCR. Gene expression profile assays may have a role in decision making in young women in need of neoadjuvant therapy.
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收藏
页码:157 / 165
页数:9
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