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dc.contributor.authorBuus, R
dc.contributor.authorSestak, I
dc.contributor.authorKronenwett, R
dc.contributor.authorDenkert, C
dc.contributor.authorDubsky, P
dc.contributor.authorKrappmann, K
dc.contributor.authorScheer, M
dc.contributor.authorPetry, C
dc.contributor.authorCuzick, J
dc.contributor.authorDowsett, M
dc.date.accessioned2016-09-05T11:15:08Z
dc.date.issued2016-11
dc.identifier.citationJournal of the National Cancer Institute, 2016, 108 (11)
dc.identifier.issn0027-8874
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/91
dc.identifier.eissn1460-2105
dc.identifier.doi10.1093/jnci/djw149
dc.description.abstractBackground Estimating distant recurrence (DR) risk among women with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 (HER2)-negative early breast cancer helps decisions on using adjuvant chemotherapy. The 21-gene Oncotype DX recurrence score (RS) is widely used for this. EndoPredict (EPclin) is an alternative test combining prognostic information from an eight-gene signature (EP score) with tumor size and nodal status. We compared the prognostic information provided by RS and EPclin for 10-year DR risk.Methods We used likelihood ratio χ² and Kaplan-Meier survival analyses to compare prognostic information provided by EP, EPclin, RS, and the clinical treatment score (CTS) of clinicopathologic parameters in 928 patients with ER+ disease treated with five years' anastrozole or tamoxifen. Comparisons were made for early (0-5 years) and late (5-10 years) DR according to nodal status. All statistical tests were two-sided.Results In the overall population, EP and EPclin provided substantially more prognostic information than RS (LRχ(2): EP = 49.3; LRχ(2): EPclin = 139.3; LRχ(2): RS = 29.1), with greater differences in late DR and in node-positive patients. EP and EPclin remained statistically significantly prognostic when adjusted for RS (ΔLRχ(2): EP+RS vs RS = 20.2; ΔLRχ(2): EPclin+RS vs RS = 113.8). Using predefined cut-offs, EPclin and RS identified 58.8% and 61.7% patients as low risk, with hazard ratios for non-low vs low risk of 5.99 (95% confidence interval [CI] = 3.94 to 9.11) and 2.73 (95% CI = 1.91 to 3.89), respectively.Conclusions EP and EPclin were highly prognostic for DR in endocrine-treated patients with ER+, HER2-negative disease. EPclin provided more prognostic information than RS. This was partly but not entirely because of EPclin integrating molecular data with nodal status and tumor size.
dc.formatPrint-Electronic
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0
dc.subjectLymph Nodes
dc.subjectHumans
dc.subjectBreast Neoplasms
dc.subjectLymphatic Metastasis
dc.subjectTamoxifen
dc.subjectNitriles
dc.subjectTriazoles
dc.subjectReceptor, erbB-2
dc.subjectReceptors, Estrogen
dc.subjectAntineoplastic Agents, Hormonal
dc.subjectPrognosis
dc.subjectDisease-Free Survival
dc.subjectTumor Burden
dc.subjectLikelihood Functions
dc.subjectRisk Assessment
dc.subjectFollow-Up Studies
dc.subjectPredictive Value of Tests
dc.subjectFemale
dc.subjectKaplan-Meier Estimate
dc.subjectAnastrozole
dc.titleComparison of EndoPredict and EPclin With Oncotype DX Recurrence Score for Prediction of Risk of Distant Recurrence After Endocrine Therapy.
dc.typeJournal Article
dcterms.dateAccepted2016-05-09
rioxxterms.versionofrecord10.1093/jnci/djw149
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc/4.0
rioxxterms.licenseref.startdate2016-11
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfJournal of the National Cancer Institute
pubs.issue11
pubs.notesNo embargo
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research/Endocrinology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Endocrinology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Endocrinology/Endocrinology (hon.)
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research/Endocrinology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Endocrinology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Endocrinology/Endocrinology (hon.)
pubs.publication-statusPublished
pubs.volume108
pubs.embargo.termsNo embargo
icr.researchteamEndocrinologyen_US
dc.contributor.icrauthorDowsett, Mitchen
dc.contributor.icrauthorBuus, Richarden


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