Prediction of chemotherapy benefit by EndoPredict in patients with breast cancer who received adjuvant endocrine therapy plus chemotherapy or endocrine therapy alone

Ivana Sestak, Miguel Martín, Peter Dubsky, Ralf Kronenwett, Federico Rojo, Jack Cuzick, Martin Filipits, Amparo Ruiz, William Gradishar, Hatem Soliman, Lee Schwartzberg, Richard Buus, Dominik Hlauschek, Alvaro Rodríguez-Lescure, Michael Gnant

Research output: Contribution to journalArticle

Abstract

Purpose: EndoPredict (EPclin) is a prognostic test validated to inform decisions on adjuvant chemotherapy to endocrine therapy alone for patients with oestrogen receptor-positive, HER2-negative breast cancer. Here, we determine the performance of EPclin for estimating 10-year distant recurrence-free interval (DRFI) rates for those who received adjuvant endocrine therapy (ET) alone compared to those with chemotherapy plus endocrine therapy (ET + C). Methods: A total of 3746 women were included in this joint analysis. 2630 patients received 5 years of ET alone (ABCSG-6/8, TransATAC) and 1116 patients received ET + C (GEICAM 2003-02/9906). The primary objective was to evaluate the ability of EPclin to provide an estimate of the 10-year DR rate as a continuous function of EPclin separately for ET alone and ET + C. Cox proportional hazard models were used for these analyses. Results: EPclin was highly prognostic for DR in women who received ET alone (HR 2.79 (2.49–3.13), P < 0.0001) as well as in those who received ET + C (HR 2.27 (1.99–2.59), P < 0.0001). Women who received ET + C had significantly smaller increases in 10-year DR rates with the increasing EPclin score than those receiving ET alone (EPclin = 5; 12% ET + C vs. 20% ET alone). We observed a significant positive interaction between EPclin and treatment groups (P-interaction = 0.022). Conclusions: In this comparative non-randomised analysis, the rate of increase in DR with EPclin score was significantly reduced in women who received ET + C versus ET alone. Our indirect comparisons suggest that a high EPclin score can predict chemotherapy benefit in women with ER-positive, HER2-negative disease.

Original languageEnglish (US)
Pages (from-to)377-386
Number of pages10
JournalBreast Cancer Research and Treatment
Volume176
Issue number2
DOIs
StatePublished - Jul 30 2019

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Breast Neoplasms
Drug Therapy
Therapeutics
Adjuvant Chemotherapy
Proportional Hazards Models
Estrogen Receptors
Recurrence

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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Prediction of chemotherapy benefit by EndoPredict in patients with breast cancer who received adjuvant endocrine therapy plus chemotherapy or endocrine therapy alone. / Sestak, Ivana; Martín, Miguel; Dubsky, Peter; Kronenwett, Ralf; Rojo, Federico; Cuzick, Jack; Filipits, Martin; Ruiz, Amparo; Gradishar, William; Soliman, Hatem; Schwartzberg, Lee; Buus, Richard; Hlauschek, Dominik; Rodríguez-Lescure, Alvaro; Gnant, Michael.

In: Breast Cancer Research and Treatment, Vol. 176, No. 2, 30.07.2019, p. 377-386.

Research output: Contribution to journalArticle

Sestak, I, Martín, M, Dubsky, P, Kronenwett, R, Rojo, F, Cuzick, J, Filipits, M, Ruiz, A, Gradishar, W, Soliman, H, Schwartzberg, L, Buus, R, Hlauschek, D, Rodríguez-Lescure, A & Gnant, M 2019, 'Prediction of chemotherapy benefit by EndoPredict in patients with breast cancer who received adjuvant endocrine therapy plus chemotherapy or endocrine therapy alone', Breast Cancer Research and Treatment, vol. 176, no. 2, pp. 377-386. https://doi.org/10.1007/s10549-019-05226-8
Sestak, Ivana ; Martín, Miguel ; Dubsky, Peter ; Kronenwett, Ralf ; Rojo, Federico ; Cuzick, Jack ; Filipits, Martin ; Ruiz, Amparo ; Gradishar, William ; Soliman, Hatem ; Schwartzberg, Lee ; Buus, Richard ; Hlauschek, Dominik ; Rodríguez-Lescure, Alvaro ; Gnant, Michael. / Prediction of chemotherapy benefit by EndoPredict in patients with breast cancer who received adjuvant endocrine therapy plus chemotherapy or endocrine therapy alone. In: Breast Cancer Research and Treatment. 2019 ; Vol. 176, No. 2. pp. 377-386.
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abstract = "Purpose: EndoPredict (EPclin) is a prognostic test validated to inform decisions on adjuvant chemotherapy to endocrine therapy alone for patients with oestrogen receptor-positive, HER2-negative breast cancer. Here, we determine the performance of EPclin for estimating 10-year distant recurrence-free interval (DRFI) rates for those who received adjuvant endocrine therapy (ET) alone compared to those with chemotherapy plus endocrine therapy (ET + C). Methods: A total of 3746 women were included in this joint analysis. 2630 patients received 5 years of ET alone (ABCSG-6/8, TransATAC) and 1116 patients received ET + C (GEICAM 2003-02/9906). The primary objective was to evaluate the ability of EPclin to provide an estimate of the 10-year DR rate as a continuous function of EPclin separately for ET alone and ET + C. Cox proportional hazard models were used for these analyses. Results: EPclin was highly prognostic for DR in women who received ET alone (HR 2.79 (2.49–3.13), P < 0.0001) as well as in those who received ET + C (HR 2.27 (1.99–2.59), P < 0.0001). Women who received ET + C had significantly smaller increases in 10-year DR rates with the increasing EPclin score than those receiving ET alone (EPclin = 5; 12{\%} ET + C vs. 20{\%} ET alone). We observed a significant positive interaction between EPclin and treatment groups (P-interaction = 0.022). Conclusions: In this comparative non-randomised analysis, the rate of increase in DR with EPclin score was significantly reduced in women who received ET + C versus ET alone. Our indirect comparisons suggest that a high EPclin score can predict chemotherapy benefit in women with ER-positive, HER2-negative disease.",
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T1 - Prediction of chemotherapy benefit by EndoPredict in patients with breast cancer who received adjuvant endocrine therapy plus chemotherapy or endocrine therapy alone

AU - Sestak, Ivana

AU - Martín, Miguel

AU - Dubsky, Peter

AU - Kronenwett, Ralf

AU - Rojo, Federico

AU - Cuzick, Jack

AU - Filipits, Martin

AU - Ruiz, Amparo

AU - Gradishar, William

AU - Soliman, Hatem

AU - Schwartzberg, Lee

AU - Buus, Richard

AU - Hlauschek, Dominik

AU - Rodríguez-Lescure, Alvaro

AU - Gnant, Michael

PY - 2019/7/30

Y1 - 2019/7/30

N2 - Purpose: EndoPredict (EPclin) is a prognostic test validated to inform decisions on adjuvant chemotherapy to endocrine therapy alone for patients with oestrogen receptor-positive, HER2-negative breast cancer. Here, we determine the performance of EPclin for estimating 10-year distant recurrence-free interval (DRFI) rates for those who received adjuvant endocrine therapy (ET) alone compared to those with chemotherapy plus endocrine therapy (ET + C). Methods: A total of 3746 women were included in this joint analysis. 2630 patients received 5 years of ET alone (ABCSG-6/8, TransATAC) and 1116 patients received ET + C (GEICAM 2003-02/9906). The primary objective was to evaluate the ability of EPclin to provide an estimate of the 10-year DR rate as a continuous function of EPclin separately for ET alone and ET + C. Cox proportional hazard models were used for these analyses. Results: EPclin was highly prognostic for DR in women who received ET alone (HR 2.79 (2.49–3.13), P < 0.0001) as well as in those who received ET + C (HR 2.27 (1.99–2.59), P < 0.0001). Women who received ET + C had significantly smaller increases in 10-year DR rates with the increasing EPclin score than those receiving ET alone (EPclin = 5; 12% ET + C vs. 20% ET alone). We observed a significant positive interaction between EPclin and treatment groups (P-interaction = 0.022). Conclusions: In this comparative non-randomised analysis, the rate of increase in DR with EPclin score was significantly reduced in women who received ET + C versus ET alone. Our indirect comparisons suggest that a high EPclin score can predict chemotherapy benefit in women with ER-positive, HER2-negative disease.

AB - Purpose: EndoPredict (EPclin) is a prognostic test validated to inform decisions on adjuvant chemotherapy to endocrine therapy alone for patients with oestrogen receptor-positive, HER2-negative breast cancer. Here, we determine the performance of EPclin for estimating 10-year distant recurrence-free interval (DRFI) rates for those who received adjuvant endocrine therapy (ET) alone compared to those with chemotherapy plus endocrine therapy (ET + C). Methods: A total of 3746 women were included in this joint analysis. 2630 patients received 5 years of ET alone (ABCSG-6/8, TransATAC) and 1116 patients received ET + C (GEICAM 2003-02/9906). The primary objective was to evaluate the ability of EPclin to provide an estimate of the 10-year DR rate as a continuous function of EPclin separately for ET alone and ET + C. Cox proportional hazard models were used for these analyses. Results: EPclin was highly prognostic for DR in women who received ET alone (HR 2.79 (2.49–3.13), P < 0.0001) as well as in those who received ET + C (HR 2.27 (1.99–2.59), P < 0.0001). Women who received ET + C had significantly smaller increases in 10-year DR rates with the increasing EPclin score than those receiving ET alone (EPclin = 5; 12% ET + C vs. 20% ET alone). We observed a significant positive interaction between EPclin and treatment groups (P-interaction = 0.022). Conclusions: In this comparative non-randomised analysis, the rate of increase in DR with EPclin score was significantly reduced in women who received ET + C versus ET alone. Our indirect comparisons suggest that a high EPclin score can predict chemotherapy benefit in women with ER-positive, HER2-negative disease.

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