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Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study
Multiparametric assays for risk stratification are widely used in the management of both node negative and node positive hormone receptor positive invasive breast cancer. Recent data from multiple sources suggests that different tests may provide different risk estimates at the individual patient le...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266887/ https://www.ncbi.nlm.nih.gov/pubmed/34238931 http://dx.doi.org/10.1038/s41523-021-00297-7 |
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author | Bartlett, John M. S. Bayani, Jane Kornaga, Elizabeth Xu, Keying Pond, Greg R. Piper, Tammy Mallon, Elizabeth Yao, Cindy Q. Boutros, Paul C. Hasenburg, Annette Dunn, J. A. Markopoulos, Christos Dirix, Luc Seynaeve, Caroline van de Velde, Cornelis J. H. Stein, Robert C. Rea, Daniel |
author_facet | Bartlett, John M. S. Bayani, Jane Kornaga, Elizabeth Xu, Keying Pond, Greg R. Piper, Tammy Mallon, Elizabeth Yao, Cindy Q. Boutros, Paul C. Hasenburg, Annette Dunn, J. A. Markopoulos, Christos Dirix, Luc Seynaeve, Caroline van de Velde, Cornelis J. H. Stein, Robert C. Rea, Daniel |
author_sort | Bartlett, John M. S. |
collection | PubMed |
description | Multiparametric assays for risk stratification are widely used in the management of both node negative and node positive hormone receptor positive invasive breast cancer. Recent data from multiple sources suggests that different tests may provide different risk estimates at the individual patient level. The TEAM pathology study consists of 3284 postmenopausal ER+ve breast cancers treated with endocrine therapy Using genes comprising the following multi-parametric tests OncotypeDx(®), Prosigna™ and MammaPrint(®) signatures were trained to recapitulate true assay results. Patients were then classified into risk groups and survival assessed. Whilst likelihood χ(2) ratios suggested limited value for combining tests, Kaplan–Meier and LogRank tests within risk groups suggested combinations of tests provided statistically significant stratification of potential clinical value. Paradoxically whilst Prosigna-trained results stratified Oncotype-trained subgroups across low and intermediate risk categories, only intermediate risk Prosigna-trained cases were further stratified by Oncotype-trained results. Both Oncotype-trained and Prosigna-trained results further stratified MammaPrint-trained low risk cases, and MammaPrint-trained results also stratified Oncotype-trained low and intermediate risk groups but not Prosigna-trained results. Comparisons between existing multiparametric tests are challenging, and evidence on discordance between tests in risk stratification presents further dilemmas. Detailed analysis of the TEAM pathology study suggests a complex inter-relationship between test results in the same patient cohorts which requires careful evaluation regarding test utility. Further prognostic improvement appears both desirable and achievable. |
format | Online Article Text |
id | pubmed-8266887 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-82668872021-07-23 Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study Bartlett, John M. S. Bayani, Jane Kornaga, Elizabeth Xu, Keying Pond, Greg R. Piper, Tammy Mallon, Elizabeth Yao, Cindy Q. Boutros, Paul C. Hasenburg, Annette Dunn, J. A. Markopoulos, Christos Dirix, Luc Seynaeve, Caroline van de Velde, Cornelis J. H. Stein, Robert C. Rea, Daniel NPJ Breast Cancer Article Multiparametric assays for risk stratification are widely used in the management of both node negative and node positive hormone receptor positive invasive breast cancer. Recent data from multiple sources suggests that different tests may provide different risk estimates at the individual patient level. The TEAM pathology study consists of 3284 postmenopausal ER+ve breast cancers treated with endocrine therapy Using genes comprising the following multi-parametric tests OncotypeDx(®), Prosigna™ and MammaPrint(®) signatures were trained to recapitulate true assay results. Patients were then classified into risk groups and survival assessed. Whilst likelihood χ(2) ratios suggested limited value for combining tests, Kaplan–Meier and LogRank tests within risk groups suggested combinations of tests provided statistically significant stratification of potential clinical value. Paradoxically whilst Prosigna-trained results stratified Oncotype-trained subgroups across low and intermediate risk categories, only intermediate risk Prosigna-trained cases were further stratified by Oncotype-trained results. Both Oncotype-trained and Prosigna-trained results further stratified MammaPrint-trained low risk cases, and MammaPrint-trained results also stratified Oncotype-trained low and intermediate risk groups but not Prosigna-trained results. Comparisons between existing multiparametric tests are challenging, and evidence on discordance between tests in risk stratification presents further dilemmas. Detailed analysis of the TEAM pathology study suggests a complex inter-relationship between test results in the same patient cohorts which requires careful evaluation regarding test utility. Further prognostic improvement appears both desirable and achievable. Nature Publishing Group UK 2021-07-08 /pmc/articles/PMC8266887/ /pubmed/34238931 http://dx.doi.org/10.1038/s41523-021-00297-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Bartlett, John M. S. Bayani, Jane Kornaga, Elizabeth Xu, Keying Pond, Greg R. Piper, Tammy Mallon, Elizabeth Yao, Cindy Q. Boutros, Paul C. Hasenburg, Annette Dunn, J. A. Markopoulos, Christos Dirix, Luc Seynaeve, Caroline van de Velde, Cornelis J. H. Stein, Robert C. Rea, Daniel Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study |
title | Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study |
title_full | Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study |
title_fullStr | Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study |
title_full_unstemmed | Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study |
title_short | Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study |
title_sort | comparative survival analysis of multiparametric tests—when molecular tests disagree—a team pathology study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266887/ https://www.ncbi.nlm.nih.gov/pubmed/34238931 http://dx.doi.org/10.1038/s41523-021-00297-7 |
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