乳腺癌
阶段(地层学)
医学
肿瘤科
内科学
癌症
妇科
生物
古生物学
作者
Guillermo Villacampa,Tomás Pascual,Fara Brasó-Maristany,Laia Paré,Olga Martínez-Sáez,Javier Cortés,Eva Ciruelos,Miguel Martín,Pier Franco Conte,Lisa A. Carey,Aranzazu Fernández-Martínez,Nadia Harbeck,Mercedes Marín-Aguilera,Ana Vivancos,Giuseppe Curigliano,Patricia Villagrasa,Joel S. Parker,Charles M. Perou,Aleix Prat,Sara M. Tolaney
出处
期刊:ESMO open
[Elsevier]
日期:2024-03-01
卷期号:9 (3): 102388-102388
标识
DOI:10.1016/j.esmoop.2024.102388
摘要
Background
The HER2DX risk-score has undergone rigorous validation in prior investigations involving patients with early-stage human epidermal growth factor receptor 2 (HER2)-positive (HER2+) breast cancer. In this study, we present the outcomes of the HER2DX risk-score within the most recent release of the Sweden Cancerome Analysis Network—Breast (SCAN-B) HER2+ cohort. This updated examination benefits from a larger patient sample, an extended follow-up duration, and detailed treatment information. Materials and methods
Clinical and RNAseq data from the SCAN-B dataset were retrieved from Gene Expression Omnibus (GSE81538). Among the 6600 patients, 819 had HER2+ breast cancer, with 757 individuals with research-based HER2DX risk-scores and corresponding survival outcomes. The HER2DX risk-score was evaluated (i) as a continuous variable and (ii) using predefined cut-offs. The primary endpoint for this study was overall survival (OS). The Kaplan–Meier method and Cox models were used to estimate OS and a multistate model with four states was fitted to better characterize patients' follow-up. Results
The median follow-up time was 7.5 years (n = 757). The most common systemic therapy was chemotherapy with trastuzumab (82.0%) and most tumors were classified as T1-T2 (97.1%). The HER2DX risk-score as a continuous variable was significantly associated with OS after adjustment for clinical variables and treatment regimen [hazard ratios (HR) per 10-unit increment = 1.31, 95% confidence interval (CI) 1.13-1.51, P < 0.001] as well as within predefined risk groups (high versus low; HR = 2.57, 95% CI 1.36-4.85, P < 0.001). Patients classified as HER2DX high-risk also had higher risk of (i) breast cancer recurrence and (ii) death without previous recurrence. Within the subgroup of HER2+ T1N0 tumors (n = 297), those classified as high-risk demonstrated inferior OS compared to low-risk tumors (7-year OS 77.8% versus 96.8%, P < 0.001). The HER2DX mRNA ERBB2 score was associated with clinical HER2 status (area under the receiver operating characteristic curve = 0.91). Conclusions
In patients with early-stage HER2+ breast cancer, HER2DX risk-score provides prognostic information beyond clinicopathological variables, including treatment regimen with or without trastuzumab.
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