PREDICT underestimates survival of patients with HER2-positive early-stage breast cancer.
Date
2022-07-20ICR Author
Author
Agostinetto, E
Ameye, L
Martel, S
Aftimos, P
Pondé, N
Maurer, C
El-Abed, S
Wang, Y
Vicente, M
Chumsri, S
Bliss, J
Kroep, J
Colleoni, M
Petrelli, F
Del Mastro, L
Moreno-Aspitia, A
Piccart, M
Paesmans, M
de Azambuja, E
Lambertini, M
Type
Journal Article
Metadata
Show full item recordAbstract
The prognostic performance of PREDICT in patients with HER2-positive early breast cancer (EBC) treated in the modern era with effective chemotherapy and anti-HER2 targeted therapies is unclear. Therefore, we investigated its prognostic performance using data extracted from ALTTO, a phase III trial evaluating adjuvant lapatinib ± trastuzumab vs. trastuzumab alone in patients with HER2-positive EBC. Our analysis included 2794 patients. After a median follow-up of 6.0 years (IQR, 5.8-6.7), 182 deaths were observed. Overall, PREDICT underestimated 5-year OS by 6.7% (95% CI, 5.8-7.6): observed 5-year OS was 94.7% vs. predicted 88.0%. The underestimation was consistent across all subgroups, including those according to the type of anti HER2-therapy. The highest absolute differences were observed for patients with hormone receptor negative-disease, nodal involvement, and large tumor size (13.0%, 15.8%, and 15.3%, respectively). AUC under the ROC curve was 73.7% (95% CI 69.7-77.8) in the overall population, ranging between 61.7% and 77.7% across the analyzed subgroups. In conclusion, our analysis showed that PREDICT highly underestimated OS in HER2-positive EBC. Hence, it should be used with caution to give prognostic estimation to HER2-positive EBC patients treated in the modern era with effective chemotherapy and anti-HER2 targeted therapies.
Collections
Subject
Science & Technology
Life Sciences & Biomedicine
Oncology
RANDOMIZED CONTROLLED-TRIALS
PLUS ADJUVANT CHEMOTHERAPY
70-GENE SIGNATURE
PROGNOSTIC MODEL
FOLLOW-UP
TRASTUZUMAB
VALIDATION
LAPATINIB
Research team
Clin Trials & Stats Unit
Language
eng
Date accepted
2022-07-01
License start date
2022-07-20
Citation
npj Breast Cancer, 2022, 8 (1), pp. 87 -
Publisher
NATURE PORTFOLIO