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Watanabe A, Tsunashima R, Kato C, Kitano S, Matsumoto S, Sota Y, Morita M, Sakaguchi K, Naoi Y. Investigation of recurrence prediction ability of EndoPredict ® using microarray data from fresh frozen tissues in ER-positive, HER2-negative breast cancer and indication expansion of EndoPredict ® from microarray data from fresh-frozen to FFPE tissues. Breast Cancer 2024; 31:593-606. [PMID: 38587783 DOI: 10.1007/s12282-024-01573-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND EndoPredict® (EP) is a multigene assay to predict distant recurrence risk in luminal breast cancer. EP measures the expression of 12 genes in primary tumor by qRT-PCR from formalin-fixed paraffin-embedded (FFPE) tissues and calculates EP risk score that indicates the risk of distant recurrence. We evaluated the performance of EP in predicting distant recurrence risk using microarray data from fresh frozen (FF) tissues. We also examined the applicability of EP to microarray data from FFPE tissues. METHODS We analyzed the publicly available data of 431 node-negative and 270 node-positive patients with luminal breast cancer who received endocrine therapy alone. We evaluated the prognostic value of EP using microarray data from FF tissues. Next, we created an algorithm to calculate EP risk score using microarray data from FFPE tissues. We examined the correlation coefficient of EP risk score and concordance rate of EP risk high/low using microarray data from FFPE/FF tissue pairs in a validation set of 39 patients. RESULTS In 431 node-negative patients, the distant recurrence-free survival (DRFS) rate was significantly worse in those with high EP risk scores (P = 3.68 × 10-6, log-rank). The 5-year DRFS was 95.2% in those with low EP risk score. In the validation set, the correlation coefficient of EP risk score was 0.93 and the concordance rate of EP risk high/low was 91.7%. CONCLUSIONS EP using microarray data from FF tissues was useful in predicting distant recurrence risk in luminal breast cancer, and EP might be utilized in microarray data from FFPE tissues.
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Affiliation(s)
- Akira Watanabe
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Tsunashima
- Department of Breast and Endocrine Surgery, Rinku General Medical Center, Osaka, Japan.
| | - Chikage Kato
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sae Kitano
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Saya Matsumoto
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiaki Sota
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Midori Morita
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Sakaguchi
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasuto Naoi
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Kitano S, Tsunashima R, Kato C, Watanabe A, Sota Y, Matsumoto S, Morita M, Sakaguchi K, Naoi Y. Validation of late recurrence prediction by gene expression profiles and clinicopathological factors in estrogen receptor-positive breast cancer. Breast Cancer 2024:10.1007/s12282-024-01602-5. [PMID: 38862868 DOI: 10.1007/s12282-024-01602-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND The mechanism of late recurrence (LR) of estrogen receptor (ER)-positive breast cancer remains unclear, as previous studies have separately investigated "gene expression profiles" and "clinicopathological factors." Thus, this study aimed to evaluate the predictive capability of LR by combining the two independent factors of gene expression profiles (42-gene classifier: 42GC) and clinicopathological factors (Clinical Treatment Score post-5 years: CTS5) in multiple large cohorts. METHODS We analyzed microarray CEL file data downloaded from public databases of 28 global cohorts. A total of 2,454 patients with ER-positive breast cancer were analyzed for 42GC, and 1,263 of these, with complete clinicopathological data were analyzed for CTS5. RESULTS In the analysis of recurrent patients, the 42GC LR and CTS5 low-risk group tended to have LR. Notably, in the analysis of patients with and without recurrence, the highest LR rate beyond 5 years was observed in the CTS5 high-risk group. The combination of the 42GC and CTS5 high-risk groups showed the highest LR rate (16.9%), significantly exceeding that of the 42GC non-LR (NLR) and CTS5 low-risk combination (5.41%) (p = 0.038, odds ratio = 3.53). Furthermore, incorporating a third factor, 95GC, potentially reduced the number of patients prioritized for extended hormonal therapy for approximately one-quarter of patients. CONCLUSIONS Results confirmed that the two factors, gene expression profiles and clinicopathological factors, affect the time of recurrence. It also showed that the biological predisposition for LR (CTS5 low-risk) differed from the high LR rate (CTS5 high-risk). In clinical practice, patients with the 42GC LR and CTS5 high-risk combination should be prioritized for extended hormonal therapy. The addition of CTS5 and 95GC to 42GC allows for better risk classification of LR.
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Affiliation(s)
- Sae Kitano
- Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Ryo Tsunashima
- Department of Breast and Endocrine Surgery, Rinku General Medical Center, Rinku Ourai Kita 2-23, Izumisanoshi, Osaka, 598-8577, Japan.
| | - Chikage Kato
- Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Akira Watanabe
- Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Yoshiaki Sota
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Saya Matsumoto
- Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Midori Morita
- Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Koichi Sakaguchi
- Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Yasuto Naoi
- Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
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Fujiki Y, Kashiwaba M, Sato M, Kawano J, Teraoka M, Kanemitsu S, Rai Y, Taira T, Sagara Y, Ohi Y, Jo U, Lee YW, Lee SB, Gong G, Shin YK, Kwon MJ, Sagara Y. Long-term prognostic value of the GenesWell BCT score in Asian women with hormone receptor-positive/HER2-negative early breast cancer. Breast Cancer 2024; 31:31-41. [PMID: 37812303 PMCID: PMC10764379 DOI: 10.1007/s12282-023-01509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Accurate prediction of the risk of recurrence is crucial for optimal treatment decisions in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative early breast cancer. The GenesWell BCT is a molecular assay to predict the 10-year risk of distant metastasis. In this study, we evaluated the long-term prognostic value of the GenesWell BCT assay. METHODS The BCT score was assessed in patients with HR-positive/HER2-negative early breast cancer who did not receive chemotherapy. We compared the 15-year distant metastasis-free survival (DMFS) between risk groups classified based on the BCT score. The risk of early (0-5 years) and late (5-15 years) recurrence was evaluated based on the BCT score classification. RESULTS According to the BCT score, 366 patients from Japan and Korea were categorized as BCT low risk (83.6%) and high risk (16.4%) for distant metastasis. Median follow-up time was 17.4 years. The 15-year DMFS rate was significantly lower in the BCT high-risk group (63.3%) than in the BCT low-risk group (93.6%) (P < 0.001). The BCT risk group was an independent prognostic factor for 15-year DMFS (hazard ratio, 4.59; 95% confidence interval 2.13-9.88; P < 0.001). Furthermore, the BCT score was a significant predictor of late recurrence (5-15 years) in patients aged ≤ 50 years and those aged > 50 years, and added prognostic information to traditional clinical prognostic factors. CONCLUSION The BCT score can identify patients at low risk for recurrence who may not require adjuvant chemotherapy or extended endocrine therapy, regardless of age.
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Affiliation(s)
- Yoshitaka Fujiki
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan
| | - Masahiro Kashiwaba
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan
| | - Mutsumi Sato
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan
| | - Junko Kawano
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan
| | - Megumi Teraoka
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan
| | - Shuichi Kanemitsu
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan
| | - Yoshiaki Rai
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan
| | - Tetsuhiko Taira
- Department of Medical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, Kagoshima, Japan
| | - Yoshiaki Sagara
- Department of Radiology, Hakuaikai Social Medical Corporation, Sagara Hospital, Kagoshima, Japan
| | - Yasuyo Ohi
- Department of Pathology, Hakuaikai Social Medical Corporation, Sagara Hospital, Kagoshima, Japan
| | - Uiree Jo
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Young-Won Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sae Byul Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Gyungyub Gong
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Young Kee Shin
- Laboratory of Molecular Pathology and Cancer Genomics, Research Institute of Pharmaceutical Sciences and College of Pharmacy, Seoul National University, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Mi Jeong Kwon
- Vessel-Organ Interaction Research Center, College of Pharmacy, Kyungpook National University, 80 Daehak-Ro, Buk-Gu, Daegu, 41566, Republic of Korea.
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea.
| | - Yasuaki Sagara
- Department of Breast and Endocrine Surgical Oncology, Hakuaikai Social Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0098, Japan.
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Shen K, Yao L, Zhu J, Gu X, Wang J, Qian W, Zheng Z, Fu D, Wu S. Impact of adjuvant chemotherapy on T1N0M0 breast cancer patients: a propensity score matching study based on SEER database and external cohort. BMC Cancer 2022; 22:863. [PMID: 35941565 PMCID: PMC9358893 DOI: 10.1186/s12885-022-09952-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/25/2022] [Indexed: 12/05/2022] Open
Abstract
Background There is no clear consensus on the benefits of adjuvant chemotherapy for tumor-node-metastasis (TNM) stage T1 (T1N0M0) breast cancer (BC). Our study investigated the effects of adjuvant chemotherapy on T1N0M0 BC patients. Methods Seventy-five thousand one hundred thirty-nine patients diagnosed with T1N0M0 BC were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox analyses were performed to investigate the effects of adjuvant chemotherapy on T1a, T1b, and T1cN0M0 BC, including various tumor grades, and four molecular subtypes. Propensity score matching (PSM) was used to eliminate confounding factors and further compare the results between adjuvant chemotherapy and no adjuvant chemotherapy. Additionally, 545 T1N0M0 BC patients treated at the Northern Jiangsu People’s Hospital were included as an independent external validation cohort. Univariate and multivariate Cox analyses were used to confirm the effects of adjuvant chemotherapy in T1a, T1b, and T1cN0M0 BC. Survival curves for the different tumor grades and molecular subtypes were plotted using the Kaplan–Meier method. Results Adjuvant chemotherapy demonstrated a statistically significant improvement in overall survival (OS) in T1b and T1c BC, but not in T1a BC. Within T1b BC, adjuvant chemotherapy was found to have effects on grade III, and hormone receptor + (HoR +)/human epidermal growth factor receptor 2 + (HER2 +), HoR-/HER2 + , and HoR-/HER2- molecular subtypes, respectively. Adjuvant chemotherapy was beneficial to OS for grade II/III and T1c BC. Identical results were obtained after PSM. We also obtained similar results with external validation cohort, except that adjuvant chemotherapy made a difference in grade II and T1b BC of the external validation dataset. Conclusions Partial T1N0M0 BC patients with grade III T1bN0M0, patients with tumor grade II and III T1cN0M0, and excluding those with HoR + /HER2- subtype tumors, could obtain OS benefits from adjuvant chemotherapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09952-z.
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Affiliation(s)
- Kaiwen Shen
- Department of General Surgery, Traditional Chinese Medicine Hospital of Kunshan, Suzhou, 215000, Jiangsu, China
| | - Longdi Yao
- Department of General Surgery, Changxing Hospital of Traditional Chinese Medicine, Huzhou, 313100, Zhejiang, China
| | - Jingyuan Zhu
- Department of General Surgery, Traditional Chinese Medicine Hospital of Kunshan, Suzhou, 215000, Jiangsu, China
| | - Ximing Gu
- Department of General Surgery, Traditional Chinese Medicine Hospital of Kunshan, Suzhou, 215000, Jiangsu, China
| | - Jie Wang
- Department of General Surgery, Traditional Chinese Medicine Hospital of Kunshan, Suzhou, 215000, Jiangsu, China
| | - Wei Qian
- Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Zhijian Zheng
- Department of General Surgery, The First People's Hospital of Wenling, Wenling, 317500, Zhejiang, China
| | - Deyuan Fu
- Department of Thyroid and Breast Surgery, Northern Jiangsu People's Hospital, Yangzhou University Medical Academy, Guangling District, Nantong Xi Road, Yangzhou, 225001, Jiangsu, China.
| | - Song Wu
- Department of Thyroid and Breast Surgery, The First People's Hospital of Wenling, Chuanan Nan Road, Chengxi Street, Wenling, 317500, Zhejiang, China.
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