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Validation of the OncoMasTR Risk Score in Estrogen Receptor-Positive/HER2-Negative Patients: A TransATAC study.

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Date
2020-02
ICR Author
Buus, Richard
Dowsett, Mitch
Author
Buus, R
Sestak, I
Barron, S
Loughman, T
Fender, B
Ruiz, CL
Dynoodt, P
Wang, C-JA
O'Leary, D
Gallagher, WM
Dowsett, M
Cuzick, J
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Type
Journal Article
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Abstract
Purpose To test the validity of OncoMasTR Molecular Score (OMm), OMclin1, and OncoMasTR Risk Score (OMclin2) prognostic scores for prediction of distant recurrence (DR) in estrogen receptor (ER)-positive/HER2-negative breast cancer treated with 5 years' endocrine therapy only and compare their performance with the Oncotype DX Recurrence Score (RS).Experimental design OMm incorporates three master transcription regulator genes. OMclin1 combines OMm, tumor size, grade, and nodal status; OMclin2 incorporates OMm, tumor size, and nodal status. OMclin1 and OMclin2 were evaluated for 646 postmenopausal patients with ER-positive/HER2-negative primary breast cancer with 0-3 involved lymph nodes in TransATAC. Patients were randomized to 5 years' anastrozole or tamoxifen without chemotherapy. RS was available in all cases. We used likelihood ratio- χ 2 , C-index, and Kaplan-Meier analyses to assess prognostic information.Results OMm, OMclin1, and OMclin2 were highly prognostic for prediction of DR in years 0-10 among all patients [likelihood ratio (LR)- χ 2 = 25.4, 48.7, and 45.0, respectively, all P < 0.001; C-index = 0.67, 0.71, and 0.71, respectively], compared with RS (LR- χ 2 = 18.8; P < 0.001; C-index = 0.63). All three scores provided significant additional prognostic value beyond clinical treatment score, Nottingham Prognostic Index, and Ki67. OMclin1 and OMclin2 categorized 190 and 267 node-negative patients as low risk (DR rates: 2.9% and 4.9%, respectively). In comparison, RS categorized 296 node-negative patients as low-risk and 128 patients as intermediate-risk (DR rate: 6.6% and 17.3%, respectively).Conclusions OMm, OMclin1, and OMclin2 were highly prognostic for early and late DR in women with early-stage ER-positive breast cancer receiving 5 years' endocrine therapy. In TransATAC, OMclin1 and the OncoMasTR Risk Score (OMclin2) were superior to RS in identifying patients at increased risk of DR.
URI
https://repository.icr.ac.uk/handle/internal/3408
DOI
https://doi.org/10.1158/1078-0432.ccr-19-0712
Collections
  • Breast Cancer Research
  • Molecular Pathology
Subject
Humans
Breast Neoplasms
Neoplasm Recurrence, Local
Disease Progression
Tamoxifen
Receptor, erbB-2
Estrogen Receptor alpha
Receptors, Progesterone
Antineoplastic Agents, Hormonal
Neoplasm Staging
Prognosis
Survival Rate
Gene Expression Profiling
Drug Resistance, Neoplasm
Aged
Middle Aged
Female
Kruppel-Like Transcription Factors
Neoplasm Grading
Securin
Biomarkers, Tumor
Forkhead Box Protein M1
Anastrozole
Research team
Endocrinology
Language
eng
Date accepted
2019-10-18
License start date
2020-02
Citation
Clinical cancer research : an official journal of the American Association for Cancer Research, 2020, 26 (3), pp. 623 - 631

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