Département d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes (IPC), UMR1068 Inserm, 13009 Marseille, France; Faculté de Médecine, Aix-Marseille Université, 13001 Marseille, France.
Département d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes (IPC), UMR1068 Inserm, 13009 Marseille, France.
Cancer Lett. 2014 Dec 1;355(1):70-5. doi: 10.1016/j.canlet.2014.09.014. Epub 2014 Sep 10.
The EndoPredict (EP) signature is a prognostic 11-gene expression signature specifically developed in ER+/HER2- node-negative/positive breast cancer. It is associated with relapse-free survival in patients treated with adjuvant hormone therapy, suggesting that EP low-risk patients could be treated with adjuvant hormone therapy alone whereas high-risk patients would deserve addition of adjuvant chemotherapy. Thus, it is important to determine whether EP high-risk patients are or are not more sensitive to chemotherapy than low-risk patients. Here, we have assessed the EP predictive value for pathological complete response to neoadjuvant chemotherapy in ER+/HER2- breast cancer. We gathered gene expression and histoclinical data of 553 pre-treatment ER+/HER2- breast carcinomas treated with anthracycline-based neoadjuvant chemotherapy. We searched for correlation between the pathological complete response (pCR) and the EP score-based classification. The overall pCR rate was 12%. Fifty-one percent of samples were classified as low-risk according to the EP score and 49% as high-risk. EP classification was associated with a pCR rate of 7% in the low-risk group and 17% in the high-risk group (p < 0.001). In multivariate analysis, the EP score remained significantly associated with pCR. Many genes upregulated in the high-risk tumours were involved in cell proliferation, whereas many genes upregulated in the low-risk tumours were involved in ER-signalling and stroma. Despite higher chemosensitivity, the high-risk group was associated with worse disease-free survival. In conclusion, EP high-risk ER+/HER2- breast cancers are more likely to respond to anthracycline-based chemotherapy.
EndoPredict（EP）标志是一种专门针对 ER+/HER2- 淋巴结阴性/阳性乳腺癌开发的预后 11 基因表达标志。它与接受辅助激素治疗的患者无复发生存相关，这表明 EP 低危患者可以单独接受辅助激素治疗，而高危患者则需要添加辅助化疗。因此，确定 EP 高危患者是否比低危患者对化疗更敏感非常重要。在这里，我们评估了 EP 在 ER+/HER2- 乳腺癌新辅助化疗中的预测价值。我们收集了 553 例接受蒽环类药物新辅助化疗的 ER+/HER2- 乳腺癌患者的基因表达和组织临床数据。我们寻找了病理完全缓解（pCR）与基于 EP 评分的分类之间的相关性。总体 pCR 率为 12%。根据 EP 评分，51%的样本被归类为低危，49%为高危。EP 分类与低危组的 pCR 率为 7%和高危组的 17%相关（p<0.001）。在多变量分析中，EP 评分仍然与 pCR 显著相关。高危肿瘤中上调的许多基因参与细胞增殖，而低危肿瘤中上调的许多基因参与 ER 信号和基质。尽管化疗敏感性更高，但高危组与无病生存较差相关。总之，EP 高危 ER+/HER2- 乳腺癌更有可能对蒽环类药物化疗有反应。
