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印度队列中EndoPredict对早期乳腺癌患者个体化化疗获益的预测

Individualized Chemotherapy Benefit Prediction by EndoPredict in Patients With Early Breast Cancer in an Indian Cohort.

作者信息

Somashekhar S P, Zaveri Shabber, Vijay Devanhalli Govinda, Dattatreya Palanki Satya, Kumar Rajeev, Islahi Fatma, Bahl Charu

机构信息

Manipal Comprehensive Cancer Care Centre, Manipal Hospital, Bengaluru, Karnataka, India.

Department of Breast and Thoracic Services, HCG Cancer Centre, Ahmedabad, Gujarat, India.

出版信息

JCO Glob Oncol. 2020 Sep;6:1363-1369. doi: 10.1200/GO.20.00250.

Abstract

PURPOSE

There are new advancements in the modulation of the treatment of patients with early-stage breast cancer, including the use of several molecular profiling tests to identify or select those patients who require additional adjuvant chemotherapy together with hormonal therapy on the basis of a recurrence score. One such tool is EndoPredict (Myriad Genetics; Salt Lake City, UT), which provides support in clinical decision making. The objective of this analysis was to study the landscape of absolute chemotherapy benefit and the likelihood of recurrence within 5 to 15 years in Indian patients with breast cancer who are undergoing EndoPredict testing.

PATIENTS AND METHODS

This study included 308 patients with hormone-positive, human epidermal growth factor receptor 2-negative early breast cancer. Their postsurgical blocks were analyzed using the EndoPredict test. The MEDCALC statistical tool (Panum Education; Seoul, Republic of Korea) was used to estimate the correlation coefficient and to conduct multiple regression analysis.

RESULTS

On the basis of the EndoPredict EPclin Risk Score, 52.12% of patients were classified as being in the low-risk category and could safely forgo adjuvant chemotherapy. For every unit increase in the EPclin Risk Score, the percentage increase in absolute chemotherapy benefit was 6.82%. Similarly, the correlation between the likelihood of recurrence within 5 to 15 years and the EPclin Risk Score suggested that there is a 10.34% increase in recurrence for each unit of EPclin Risk Score.

CONCLUSION

The EPclin Risk Score has good prognostic and predictive power; it also provides the range of chemotherapy benefit for Indian patients.

摘要

目的

早期乳腺癌患者的治疗调控有了新进展,包括使用多种分子谱检测来识别或选择那些基于复发评分需要额外辅助化疗联合激素治疗的患者。EndoPredict(Myriad Genetics公司;美国犹他州盐湖城)就是这样一种工具,它为临床决策提供支持。本分析的目的是研究接受EndoPredict检测的印度乳腺癌患者的绝对化疗获益情况以及5至15年内复发的可能性。

患者与方法

本研究纳入了308例激素受体阳性、人表皮生长因子受体2阴性的早期乳腺癌患者。使用EndoPredict检测对其术后组织块进行分析。采用MEDCALC统计工具(韩国首尔Panum Education公司)来估计相关系数并进行多元回归分析。

结果

根据EndoPredict EPclin风险评分,52.12%的患者被归类为低风险类别,可以安全地放弃辅助化疗。EPclin风险评分每增加一个单位,绝对化疗获益的百分比增加6.82%。同样,5至15年内复发可能性与EPclin风险评分之间的相关性表明,EPclin风险评分每增加一个单位,复发率增加10.34%。

结论

EPclin风险评分具有良好的预后和预测能力;它还为印度患者提供了化疗获益范围。

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