Authors' Affiliations: Departments of Medicine I, Pathology, and Surgery; Department of Obstetrics and Gynecology, Comprehensive Cancer Center Vienna, Medical University of Vienna; Austrian Breast and Colorectal Cancer Study Group, Vienna; Departments of Internal Medicine III and Pathology, Paracelsus Private Medical University, Salzburg; Departments of Internal Medicine and Pathology, Medical University of Graz, Graz; Departments of Pathology and Surgery, Sisters of Charity Hospital and Cancer Center, Linz; Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck; Department of Surgery, General Hospital Baden, Baden, Austria; Myraqa, Redwood Shores, California; NanoString Technologies, Seattle, Washington; and British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Clin Cancer Res. 2014 Mar 1;20(5):1298-305. doi: 10.1158/1078-0432.CCR-13-1845. Epub 2014 Feb 11.
To assess the prognostic value of the PAM50 risk-of-recurrence (ROR) score on late distant recurrence (beyond 5 years after diagnosis and treatment) in a large cohort of postmenopausal, endocrine-responsive breast cancer patients.
The PAM50 assay was performed on formalin-fixed paraffin-embedded whole-tumor sections of patients who had been enrolled in the Austrian Breast and Colorectal Cancer Study Group Trial 8 (ABCSG-8). RNA expression levels of the PAM50 genes were determined centrally using the nCounter Dx Analysis System. Late distant recurrence-free survival (DRFS) was analyzed using Cox models adjusted for clinical and pathologic parameters.
PAM50 analysis was successfully performed in 1,246 ABCSG-8 patients. PAM50 ROR score and ROR-based risk groups provided significant additional prognostic information with respect to late DRFS compared with a combined score of clinical factors alone (ROR score: ΔLRχ(2) 15.32, P < 0.001; ROR-based risk groups: ΔLRχ(2) 14.83, P < 0.001). Between years 5 and 15, we observed an absolute risk of distant recurrence of 2.4% in the low ROR-based risk group, as compared with 17.5% in the high ROR-based risk group. The DRFS differences according to the PAM50 ROR score were observed for both node-positive and node-negative disease.
PAM50 ROR score and ROR-based risk groups can differentiate patients with breast cancer with respect to their risk for late distant recurrence beyond what can be achieved with established clinicopathologic risk factors.
在一大群绝经后、内分泌治疗有效的乳腺癌患者中，评估 PAM50 复发风险 (ROR) 评分对晚期远处复发（诊断和治疗后 5 年以上）的预后价值。
对参加奥地利乳腺癌和结直肠癌研究组试验 8 (ABCSG-8) 的患者的福尔马林固定石蜡包埋全肿瘤切片进行了 PAM50 检测。使用 nCounter Dx 分析系统集中测定了 PAM50 基因的 RNA 表达水平。使用 Cox 模型分析了晚期远处无复发生存 (DRFS)，并根据临床和病理参数进行了调整。
成功对 1246 例 ABCSG-8 患者进行了 PAM50 分析。与仅临床因素综合评分相比，PAM50 ROR 评分和基于 ROR 的风险组在晚期 DRFS 方面提供了显著的附加预后信息（ROR 评分：ΔLRχ(2) 15.32，P < 0.001；基于 ROR 的风险组：ΔLRχ(2) 14.83，P < 0.001）。在 5 年至 15 年间，我们观察到低基于 ROR 的风险组的远处复发绝对风险为 2.4%，而高基于 ROR 的风险组为 17.5%。PAM50 ROR 评分与基于 ROR 的风险组之间的 DRFS 差异在淋巴结阳性和淋巴结阴性疾病中均观察到。
PAM50 ROR 评分和基于 ROR 的风险组可区分乳腺癌患者的晚期远处复发风险，这超出了可通过既定临床病理危险因素实现的风险。
