Department of Surgery, Galway University Hospitals, Galway, Ireland.
The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
Breast J. 2021 Jun;27(6):521-528. doi: 10.1111/tbj.14217. Epub 2021 Mar 11.
Oncotype DX™ (ODX) score estimates prognosis and predicts breast cancer recurrence. It also individualizes patient adjuvant chemotherapy prescription in breast cancer. This assay relies on genetic and molecular markers; the clinicopathological phenotype of which are tested routinely. The aim of this study was determine whether clinicopathological and immunohistochemical information predicts ODX recurrence score (RS). Secondly, to assess the impact on adjuvant chemotherapy (AC) and oncological outcome of ODX testing in patients in a European tertiary referral center. Estrogen receptor positive (ER+), human epidermal growth factor receptor-2 negative (HER2-), lymph node negative (LN-), and female breast cancer patients with ODX testing performed between 2007 and 2015 were categorized into low- (<11), intermediate- (11-25), and high-risk (>25) groups. Clinicopathological and immunohistochemical correlates of RS were determined. Predictors of RS were assessed using binary logistic regression. Oncological outcome was assessed using Kaplan-Meier and Cox regression analyses. ODX was performed in 400 consecutive ER+LN- patients. Median follow-up was 74.1 months (3.0-144.4). Low grade (odds ratio [OR]:2.39; 95% confidence interval [CI]:1.04-5.51, p = 0.041) independently predicted low ODX, while high grade (OR:2.04; 95% CI: 1.19-3.49, p = 0.009) and reduced progesterone receptor (PgR) expression (OR: 2.57, 95% CI: 1.42-4.65, p = 0.002) independently predicted high ODX. Omission of AC in intermediate- (p = 0.159) and high-risk (p = 0.702) groups did not negatively impact survival. In conclusion, tumor grade independently predicts low and high RS, while PgR negativity predicts high RS. ODX reduced AC prescription without compromising oncological outcome.
Oncotype DX™（ODX）评分可评估预后并预测乳腺癌复发。它还可以为乳腺癌患者的辅助化疗方案提供个体化建议。该检测依赖于遗传和分子标志物；对其进行常规检测的临床病理表型。本研究的目的是确定临床病理和免疫组织化学信息是否可以预测 ODX 复发评分（RS）。其次，评估 ODX 检测在欧洲三级转诊中心患者中的辅助化疗（AC）和肿瘤学结果的影响。在 2007 年至 2015 年间进行 ODX 检测的雌激素受体阳性（ER+）、人表皮生长因子受体-2 阴性（HER2-）、淋巴结阴性（LN-）和女性乳腺癌患者被分为低风险（<11）、中风险（11-25）和高风险（>25）组。确定 RS 的临床病理和免疫组织化学相关性。使用二项逻辑回归评估 RS 的预测因素。使用 Kaplan-Meier 和 Cox 回归分析评估肿瘤学结果。对 400 例连续的 ER+LN-患者进行了 ODX 检测。中位随访时间为 74.1 个月（3.0-144.4）。低级别（优势比[OR]：2.39；95%置信区间[CI]：1.04-5.51，p=0.041）独立预测低 ODX，而高级别（OR：2.04；95% CI：1.19-3.49，p=0.009）和孕激素受体（PgR）表达降低（OR：2.57，95% CI：1.42-4.65，p=0.002）独立预测高 ODX。中风险（p=0.159）和高风险（p=0.702）组中省略 AC 并不影响生存。总之，肿瘤分级独立预测低和高 RS，而 PgR 阴性预测高 RS。ODX 减少了 AC 处方，而不会影响肿瘤学结果。
