Naoi Yasuto, Tsunashima Ryo, Shimazu Kenzo, Oikawa Masahiro, Imanishi Seiichi, Koyama Hiroshi, Kamada Yoshihiko, Ishihara Kazuhiro, Suzuki Masahiko, Osako Tomo, Kinoshita Takayuki, Suto Akihiko, Nakamura Seigo, Tsuda Hitoshi, Noguchi Shinzaburo
Department of Surgery, Division of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
Department of Breast Surgery, Rinku General Medical Center, Izumisano, Osaka 598-8577, Japan.
Oncol Lett. 2023 Apr 5;25(5):209. doi: 10.3892/ol.2023.13794. eCollection 2023 May.
Curebest™ 95GC breast (95GC) is a multigene classifier we developed for the prognostic prediction of patients with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative and node-negative (ER+/HER2-/n0) invasive breast cancer treated with adjuvant endocrine therapy alone. The aim of the preset study was to evaluate the clinical utility of 95GC in a multiinstitutional registry study. Patients (n=215) with ER/HER2/n0 invasive breast cancer who had undergone the 95GC assay in seven hospitals were consecutively recruited in the registry study at various postoperative times. At recruitment, no patients had disease recurrences and were prospectively followed up for a median of 62 (range, 6-91) postoperative months. Of the 124 patients classified as 95GC low risk, 118 received adjuvant endocrine therapy alone and six received adjuvant chemo-endocrine therapy. Only two patients developed distant recurrences, and the 5-year distant recurrence-free survival (DRFS) was as high as 98.0%. Of the 91 patients classified as 95GC high risk, 81 received adjuvant chemo-endocrine therapy and 10 received adjuvant endocrine therapy alone. A total of four of these patients developed distant recurrences (5-year DRFS=95.5%). Among the 95GC high-risk patients, prognosis was significantly improved for the 81 treated with adjuvant chemo-endocrine therapy compared with for the 77 (historical controls) treated with adjuvant endocrine therapy alone (P=0.0002; hazard ratio, 0.24). Compared with the St. Gallen 2013 guideline, a significant de-escalation from 73.1% (155/212) to 40.6% (86/212) in adjuvant chemotherapy was achieved. The excellent prognosis of patients with ER/HER2/n0 invasive breast cancer classified as 95GC low risk could be validated in the present registry study, indicating that 95GC is useful for safe de-escalation of adjuvant chemotherapy in patients with ER/HER2/n0 invasive breast cancer.
Curebest™ 95基因检测(95GC)是我们研发的一种多基因分类器,用于对仅接受辅助内分泌治疗的雌激素受体(ER)阳性、人表皮生长因子受体2(HER2)阴性且无淋巴结转移(ER+/HER2-/n0)的浸润性乳腺癌患者进行预后预测。本研究的目的是在一项多机构注册研究中评估95GC的临床应用价值。在七家医院接受过95GC检测的ER/HER2/n0浸润性乳腺癌患者(n = 215)在不同术后时间被连续纳入该注册研究。入组时,所有患者均无疾病复发,并进行前瞻性随访,中位随访时间为术后62个月(范围6 - 91个月)。在124例被分类为95GC低风险的患者中,118例仅接受辅助内分泌治疗,6例接受辅助化疗联合内分泌治疗。仅2例患者发生远处复发,5年远处无复发生存率(DRFS)高达98.0%。在91例被分类为95GC高风险的患者中,81例接受辅助化疗联合内分泌治疗,10例仅接受辅助内分泌治疗。这些患者中共有4例发生远处复发(5年DRFS = 95.5%)。在95GC高风险患者中,与77例(历史对照)仅接受辅助内分泌治疗的患者相比,81例接受辅助化疗联合内分泌治疗的患者预后显著改善(P = 0.0002;风险比,0.24)。与2013年圣加仑指南相比,辅助化疗的比例从73.1%(155/212)显著降至40.6%(86/212)。在本注册研究中,可验证ER/HER2/n0浸润性乳腺癌被分类为95GC低风险患者的良好预后,这表明95GC有助于安全降低ER/HER2/n0浸润性乳腺癌患者辅助化疗的强度。