Τίτλος:
Mammostrat As an Immunohistochemical Multigene Assay for Prediction of
Early Relapse Risk in the Tamoxifen Versus Exemestane Adjuvant
Multicenter Trial Pathology Study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose
Some postmenopausal patients with hormone-sensitive early breast cancer
remain at high risk of relapse despite endocrine therapy and, in
addition, might benefit from adjuvant chemotherapy. The challenge is to
prospectively identify such patients. The Mammostrat test uses five
immunohistochemical markers to stratify patients regarding recurrence
risk and may inform treatment decisions. We tested the efficacy of this
panel in the Tamoxifen versus Exemestane Adjuvant Multicenter (TEAM)
trial.
Patients and Methods
Pathology blocks from 4,598 TEAM patients were collected, and tissue
microarrays (TMAs) were constructed. The cohort was 47% node-positive,
and 36% of patients in the cohort were treated with adjuvant
chemotherapy. Triplicate 0.6-mm(2) TMA cores were stained, and
positivity for p53, HTF9C, CEACAM5, NDRG1, and SLC7A5 was assessed.
Cases were assigned a Mammostrat risk score, and distant relapse-free
survival (DRFS) and disease-free survival (DFS) were analyzed.
Results
In multivariate regression analyses, which were corrected for
conventional clinicopathologic markers, Mammostrat provided significant
additional information on DRFS after endocrine therapy in estrogen
receptor (ER) -positive node-negative patients (n = 1,226) who did not
receive chemotherapy (P=.004). Additional analyses in all patients not
exposed to chemotherapy, irrespective of nodal status (n = 2,559) and in
the entire cohort (n = 3,837) showed Mammostrat scores provided
additional information on DRFS in these groups (P=.001 and P<.001,
respectively; multivariate analyses). No differences were seen between
the two endocrine treatment regimens.
Conclusion
The Mammostrat score predicts DRFS for patients treated with exemestane
and patients treated with tamoxifen followed by exemestane irrespective
of nodal status and chemotherapy. The ability of this test to provide
additional outcome data after treatment provides additional evidence of
its use in risk stratification of ER-positive postmenopausal patients
with breast cancer. J Clin Oncol 30:4477-4484. (C) 2012 by American
Society of Clinical Oncology
Συγγραφείς:
Bartlett, John M. S.
Bloom, Kenneth J.
Piper, Tammy
Lawton,
Thomas J.
van de Velde, Cornelis J. H.
Ross, Douglas T. and
Ring, Brian Z.
Seitz, Robert S.
Beck, Rodney A.
Hasenburg,
Annette
Kieback, Dirk
Putter, Hein
Markopoulos, Christos and
Dirix, Luc
Seynaeve, Caroline
Rea, Daniel
Περιοδικό:
World Journal of Clinical Oncology
Εκδότης:
AMER SOC CLINICAL ONCOLOGY 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA
DOI:
10.1200/JCO.2012.42.8896
