TY - JOUR
T1 - 70-Gene signature-guided adjuvant systemic treatment adjustments in early-stage ER+ breast cancer patients
T2 - 7-year follow-up of a prospective multicenter cohort study
AU - Verreck, Eline E.F.
AU - Kuijer, Anne
AU - van Steenhoven, Julia E.C.
AU - Volders, José H.
AU - van der Velden, Annette W.G.
AU - Siesling, Sabine
AU - Timmer-Bonte, Anja N.H.
AU - Smilde, Tineke J.
AU - Imholz, Alex L.T.
AU - Blanken-Peeters, Charlotte F.J.M.
AU - de Valk, Bart
AU - Vrijaldenhoven, Suzan
AU - Lastdrager, Willem B.
AU - Haringhuizen, Annebeth W.
AU - Hunting, Jarmo C.B.
AU - Hovenga, Sjoerd
AU - Nieboer, Peter
AU - Zuetenhorst, Hanneke M.
AU - Tetteroo, Geert W.M.
AU - Smorenburg, Carolien H.
AU - van Maaren, Marissa C.
AU - van Dalen, Thijs
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2025/1
Y1 - 2025/1
N2 - Background: A previous prospective multicenter study revealed the change of the oncologists’ chemotherapy advice due to the 70-Gene signature (GS) test result in half of the estrogen receptor-positive (ER+) invasive early-stage breast cancer patients with disputable chemotherapy indication. This resulted in less patients receiving chemotherapy. This study aims to complement these results by the 7-year oncological outcomes according to the 70-GS test result and the oncologists’ pre-test advice. Methods: Patients operated for early-stage ER+ breast cancer with disputable chemotherapy indication, had been prospectively included between 2013 and 2015. Oncologists were asked whether they intended to administer adjuvant chemotherapy before deployment of the 70-GS test. Information on adjuvant systemic treatment and oncological outcome was obtained through active follow-up by data managers of the Netherlands Cancer Registry. The primary endpoint of this study was distant metastasis-free survival (DMFS) according to the genomic risk. Exploratory analyses were done to evaluate DMFS in relation to the oncologists’ pre-test advice. Results: After a median follow-up of 7 years, distant metastases were diagnosed in 23 of the 606 patients (3.8%) and 36 (5.9%) patients had died. The DMFS rate for the 357 70-GS genomic low-risk patients was 94.2% (95% CI 91.2–96.2) and 89.1% for the 249 genomic high-risk patients (95% CI 84.3–92.4). Of the low-risk patients 3% had received chemotherapy compared to 80% of the high-risk patients. For the subgroups based on the pre-test oncologists’ advice (no chemotherapy/chemotherapy/unsure) there were no clinically relevant differences in DMFS (89.8, 93.2 and 92.0%, respectively), while comparable proportions of patients had received chemotherapy. Conclusions: In patients with early-stage ER+ breast cancer with a disputable chemotherapy indication it is sensible to deploy the 70-GS to better select patients for adjuvant chemotherapy.
AB - Background: A previous prospective multicenter study revealed the change of the oncologists’ chemotherapy advice due to the 70-Gene signature (GS) test result in half of the estrogen receptor-positive (ER+) invasive early-stage breast cancer patients with disputable chemotherapy indication. This resulted in less patients receiving chemotherapy. This study aims to complement these results by the 7-year oncological outcomes according to the 70-GS test result and the oncologists’ pre-test advice. Methods: Patients operated for early-stage ER+ breast cancer with disputable chemotherapy indication, had been prospectively included between 2013 and 2015. Oncologists were asked whether they intended to administer adjuvant chemotherapy before deployment of the 70-GS test. Information on adjuvant systemic treatment and oncological outcome was obtained through active follow-up by data managers of the Netherlands Cancer Registry. The primary endpoint of this study was distant metastasis-free survival (DMFS) according to the genomic risk. Exploratory analyses were done to evaluate DMFS in relation to the oncologists’ pre-test advice. Results: After a median follow-up of 7 years, distant metastases were diagnosed in 23 of the 606 patients (3.8%) and 36 (5.9%) patients had died. The DMFS rate for the 357 70-GS genomic low-risk patients was 94.2% (95% CI 91.2–96.2) and 89.1% for the 249 genomic high-risk patients (95% CI 84.3–92.4). Of the low-risk patients 3% had received chemotherapy compared to 80% of the high-risk patients. For the subgroups based on the pre-test oncologists’ advice (no chemotherapy/chemotherapy/unsure) there were no clinically relevant differences in DMFS (89.8, 93.2 and 92.0%, respectively), while comparable proportions of patients had received chemotherapy. Conclusions: In patients with early-stage ER+ breast cancer with a disputable chemotherapy indication it is sensible to deploy the 70-GS to better select patients for adjuvant chemotherapy.
KW - 70-Gene Signature
KW - Chemotherapy decision
KW - Luminal breast cancer
UR - http://www.scopus.com/inward/record.url?scp=85205386297&partnerID=8YFLogxK
U2 - 10.1007/s10549-024-07496-3
DO - 10.1007/s10549-024-07496-3
M3 - Article
C2 - 39349887
AN - SCOPUS:85205386297
SN - 0167-6806
VL - 209
SP - 331
EP - 340
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 2
ER -