Walter Vincent P, Taran Florin-Andrei, Wallwiener Markus, Bauer Armin, Grischke Eva-Maria, Walter Christina Barbara, Hahn Markus, Brucker Sara Y, Hartkopf Andreas Daniel
Department of Women's Health, University of Tübingen, Tübingen, Germany.
Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany.
Geburtshilfe Frauenheilkd. 2020 Jun;80(6):619-627. doi: 10.1055/a-1111-8734. Epub 2020 Jun 17.
Multigene assays are being used increasingly to aid in decision-making about chemotherapy in breast cancer. Here, we present the 21-gene recurrence score (RS) of patients tested in routine clinical practice in Germany. In a retrospective analysis, 4695 patients with hormone receptor-positive and HER2-negative early breast cancer (pT1 - 3, pN0 - 1, M0) were included in whom RS testing was conducted in Germany between November 2015 and July 2018. RS groups as defined in the TAILORx trial (RS result 0 - 10; 11 - 25; 26 - 100) were used. Of these patients, 21% were assigned to the low RS group, 63% to the midrange RS group, and 15% to the high RS group. 1772 (81%) of 2175 node-negative patients over 50 years of age were grouped either into the low RS group or the midrange RS group. The portion of patients with a low or midrange RS was 90% among node-positive patients (1284 of 1432 patients), 79% among patients with Ki-67-high (≥ 20%) tumors (1829 of 2310 patients), 86% vs. 70% among patients with G2 and G3 tumors (3244 of 3762 patients and 368 of 522 patients), respectively, 88% among patients with a tumor size of > 5 cm (140 of 159 patients), and 82% among node-negative patients at high clinical risk (1110 of 1352). The distribution of the 21-gene RS in German patients that were tested in routine clinical practice indicates that, according to the results of the TAILORx trial, chemotherapy may not be beneficial in most of these.
多基因检测越来越多地用于辅助乳腺癌化疗的决策制定。在此，我们展示了在德国常规临床实践中接受检测的患者的21基因复发评分（RS）。在一项回顾性分析中，纳入了4695例激素受体阳性且人表皮生长因子受体2阴性的早期乳腺癌患者（pT1-3，pN0-1，M0），这些患者于2015年11月至2018年7月在德国进行了RS检测。采用了TAILORx试验中定义的RS分组（RS结果为0-10；11-25；26-100）。在这些患者中，21%被分配到低RS组，63%被分配到中等RS组，15%被分配到高RS组。2175例50岁以上的无淋巴结转移患者中有1772例（81%）被分组到低RS组或中等RS组。在有淋巴结转移的患者中（1432例患者中的1284例），低或中等RS患者的比例为90%；在Ki-67高（≥20%）肿瘤患者中（2310例患者中的1829例）为79%；在G2和G3肿瘤患者中分别为86%和70%（3762例患者中的3244例和522例患者中的368例）；肿瘤大小>5 cm的患者中为88%（159例患者中的140例）；高临床风险的无淋巴结转移患者中为82%（1352例患者中的1110例）。在德国常规临床实践中接受检测的患者中，21基因RS的分布表明，根据TAILORx试验的结果，化疗对其中大多数患者可能并无益处。
