Tal Sella1,2, Shari I Gelber1, Philip D Poorvu1,2,3, Hee-Jeong Kim4, Laura Dominici1,2,5, Yaileen D Guzman-Arocho2,6, Laura Collins2,6, Kathryn J Ruddy7, Rulla M Tamimi3,8, Jeffrey M Peppercorn2,9, Lidia Schapira10, Virginia F Borges11, Steven E Come2,6, Ellen Warner12, Craig Snow1, Debbie M Jakubowski13, Christy A Russell13, Eric P Winer1,2,3, Shoshana M Rosenberg1,2, Ann H Partridge14,15,16. 1. Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA. 2. Harvard Medical School, Boston, MA, USA. 3. Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. 4. Asan Medical Center, Seoul, Korea. 5. Divison of Breast Surgery Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. 6. Beth Israel Deaconess Medical Center, Boston, MA, USA. 7. Mayo Clinic, Department of Oncology, Rochester, MN, USA. 8. Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA. 9. Massachusetts General Hospital, Boston, MA, USA. 10. Stanford Cancer Institute, Palo Alto, CA, USA. 11. University of Colorado Comprehensive Cancer Center, Aurora, CO, USA. 12. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 13. Genomic Health, Redwood City, CA, USA. 14. Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA. Ann_partridge@dfci.harvard.edu. 15. Harvard Medical School, Boston, MA, USA. Ann_partridge@dfci.harvard.edu. 16. Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. Ann_partridge@dfci.harvard.edu.
Abstract
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, pwilcoxon = 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.
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, pwilcoxon = 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.
Entities:
Keywords:
21-gene Breast Recurrence Score; Neoadjuvant chemotherapy; Pathological complete response; Young women
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