G Viale1, F A de Snoo2, L Slaets3, J Bogaerts3, L van 't Veer4, E J Rutgers5, M J Piccart-Gebhart6, L Stork-Sloots2, A Glas2, L Russo7, P Dell'Orto7, K Tryfonidis3, S Litière3, F Cardoso8. 1. Department of Pathology, European Institute of Oncology and University of Milan, Via Ripamonti 435, 20141, Milan, Italy. giuseppe.viale@ieo.it. 2. Medical Affairs, Agendia, Amsterdam, The Netherlands. 3. European Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium. 4. Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA. 5. Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands. 6. Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 7. Department of Pathology, European Institute of Oncology and University of Milan, Via Ripamonti 435, 20141, Milan, Italy. 8. Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal.
Abstract
PURPOSE: This study compares immunohistochemical (IHC) versus molecular subtyping (BluePrint and MammaPrint) in the population of patients enrolled in MINDACT and outcome based on molecular subtyping (MS) versus surrogate pathological subtyping (PS) as defined by the 2013 St. Gallen guidelines. METHODS: MS classified patients in the following subtypes: Luminal A, Luminal B, HER-2-, and Basal-type. IHC/FISH for pathological subtyping (ER, PgR, HER-2, and Ki67) was centrally assessed in the European Institute of Oncology (n = 5806). Hazard ratios for distant-metastasis-free survival (DMFS) by subtype were adjusted for chemotherapy and endocrine therapy administration and thus independent of adjuvant treatment allocation. RESULTS: PS Luminal cancers classified as HER-2+ or Basal-type by MS did not have a significantly lower DMFS than the Luminal-type cancers by MS (95.9%): HR = 1.40, 95% CI 0.75-2.60 (p = 0.294). More patients were identified with Luminal A disease by MS (63%) as compared with PS (47%) with comparable 5-year DMFS (≥96.0%). Among the 500 patients with PS TN cancers, MS identified 24 (5%) patients as Luminal-type with 5-year DMFS estimated at 100% versus 71.4% for MS HER-2+ or 90.1% for MS Basal-type. CONCLUSIONS: MS was able to re-stratify 54% of patients with a Luminal-B PS subtype to a low-risk Luminal A-type group with comparable outcome. Among TN EBC, 5% were classified as Luminal by MS with Luminal-like outcome. Molecular classification can help to identify a larger group of patients with low risk of recurrence compared with the more contemporarily used classification methodology including high-quality assessed Ki67.
PURPOSE: This study compares immunohistochemical (IHC) versus molecular subtyping (BluePrint and MammaPrint) in the population of patients enrolled in MINDACT and outcome based on molecular subtyping (MS) versus surrogate pathological subtyping (PS) as defined by the 2013 St. Gallen guidelines. METHODS: MS classified patients in the following subtypes: Luminal A, Luminal B, HER-2-, and Basal-type. IHC/FISH for pathological subtyping (ER, PgR, HER-2, and Ki67) was centrally assessed in the European Institute of Oncology (n = 5806). Hazard ratios for distant-metastasis-free survival (DMFS) by subtype were adjusted for chemotherapy and endocrine therapy administration and thus independent of adjuvant treatment allocation. RESULTS:PS Luminal cancers classified as HER-2+ or Basal-type by MS did not have a significantly lower DMFS than the Luminal-type cancers by MS (95.9%): HR = 1.40, 95% CI 0.75-2.60 (p = 0.294). More patients were identified with Luminal A disease by MS (63%) as compared with PS (47%) with comparable 5-year DMFS (≥96.0%). Among the 500 patients with PS TN cancers, MS identified 24 (5%) patients as Luminal-type with 5-year DMFS estimated at 100% versus 71.4% for MS HER-2+ or 90.1% for MS Basal-type. CONCLUSIONS: MS was able to re-stratify 54% of patients with a Luminal-B PS subtype to a low-risk Luminal A-type group with comparable outcome. Among TN EBC, 5% were classified as Luminal by MS with Luminal-like outcome. Molecular classification can help to identify a larger group of patients with low risk of recurrence compared with the more contemporarily used classification methodology including high-quality assessed Ki67.
Entities:
Keywords:
Breast cancer; Molecular subtypes; Pathological subtyping
Authors: Keely M McNamara; Fouzia Guestini; Torill Sauer; Joel Touma; Ida Rashida Bukholm; Jonas C Lindstrøm; Hironobu Sasano; Jürgen Geisler Journal: Br J Cancer Date: 2018-03-22 Impact factor: 7.640
Authors: Giuseppe Viale; Amy E Hanlon Newell; Espen Walker; Greg Harlow; Isaac Bai; Leila Russo; Patrizia Dell'Orto; Patrick Maisonneuve Journal: Breast Cancer Res Treat Date: 2019-08-17 Impact factor: 4.872
Authors: Julia E C van Steenhoven; Anne Kuijer; Paul J van Diest; Joost M van Gorp; Marieke Straver; Sjoerd G Elias; Jelle Wesseling; Emiel Rutgers; Johanna N H Timmer-Bonte; Peter Nieboer; Tineke J Smilde; Alex Imholz; Charlotte F J M Blanken; Sabine Siesling; Thijs van Dalen Journal: Genes (Basel) Date: 2018-05-17 Impact factor: 4.096