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Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer?

The 21-gene recurrence score assay has been validated as a predictive biomarker in early-stage HR+ and HER2-breast cancer. It is not indicated for use in HER2+ disease based on national guidelines. In this study, we assessed the value of 21-gene recurrence score (RS), or OncotypeDX (ODX), testing in...

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Autores principales: Bilani, Nadeem, Crowley, Fionnuala, Mohanna, Mohamed, Itani, Mira, Yaghi, Marita, Saravia, Diana, Jabbal, Iktej, Dominguez, Barbara, Liang, Hong, Nahleh, Zeina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9493134/
https://www.ncbi.nlm.nih.gov/pubmed/36137495
http://dx.doi.org/10.1016/j.breast.2022.09.002
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author Bilani, Nadeem
Crowley, Fionnuala
Mohanna, Mohamed
Itani, Mira
Yaghi, Marita
Saravia, Diana
Jabbal, Iktej
Dominguez, Barbara
Liang, Hong
Nahleh, Zeina
author_facet Bilani, Nadeem
Crowley, Fionnuala
Mohanna, Mohamed
Itani, Mira
Yaghi, Marita
Saravia, Diana
Jabbal, Iktej
Dominguez, Barbara
Liang, Hong
Nahleh, Zeina
author_sort Bilani, Nadeem
collection PubMed
description The 21-gene recurrence score assay has been validated as a predictive biomarker in early-stage HR+ and HER2-breast cancer. It is not indicated for use in HER2+ disease based on national guidelines. In this study, we assessed the value of 21-gene recurrence score (RS), or OncotypeDX (ODX), testing in HR+/HER2+ breast cancer. We used the National Cancer Database to identify patients with stages I-II, HR+/HER2+ breast cancer who received multi-gene testing with ODX. We then explored the prognostic and predictive value of this biomarker through various forms of survival modeling. ODX testing was performed in n = 5,280 patients. N = 2,678 patients (50.7%) had a RS < 26, while n = 2,602 (49.3%) had a RS ≥26. In Kaplan-Meier survival modeling for patients with recurrence scores <26, there was no significant difference in overall survival (p = 0.445) between patients receiving different systemic treatment regimens. However, when recurrence scores were ≥26, there was a statistically-significant difference in overall survival between systemic treatment regimens (p < 0.001). 5-year overall survival was highest (97.4%) for patients receiving triple therapy (anti-HER2 with chemotherapy and endocrine therapy), followed by those receiving dual therapy with endocrine and anti-HER2 (96.7%), and endocrine with chemotherapy (94.9%). Patients receiving endocrine therapy alone exhibited the lowest 5-year overall survival (88.5%). RESULTS: Analysis from this large national cancer registry suggests that multigene testing may have predictive value in treatment selection for patients with early-stage, HR+/HER2+ breast cancer. Prospective trials are warranted to identify subgroups of patients with HR+/HER2+ breast cancer who can be spared anti-HER2 treatments and cytotoxic chemotherapy.
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spelling pubmed-94931342022-09-23 Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer? Bilani, Nadeem Crowley, Fionnuala Mohanna, Mohamed Itani, Mira Yaghi, Marita Saravia, Diana Jabbal, Iktej Dominguez, Barbara Liang, Hong Nahleh, Zeina Breast Original Article The 21-gene recurrence score assay has been validated as a predictive biomarker in early-stage HR+ and HER2-breast cancer. It is not indicated for use in HER2+ disease based on national guidelines. In this study, we assessed the value of 21-gene recurrence score (RS), or OncotypeDX (ODX), testing in HR+/HER2+ breast cancer. We used the National Cancer Database to identify patients with stages I-II, HR+/HER2+ breast cancer who received multi-gene testing with ODX. We then explored the prognostic and predictive value of this biomarker through various forms of survival modeling. ODX testing was performed in n = 5,280 patients. N = 2,678 patients (50.7%) had a RS < 26, while n = 2,602 (49.3%) had a RS ≥26. In Kaplan-Meier survival modeling for patients with recurrence scores <26, there was no significant difference in overall survival (p = 0.445) between patients receiving different systemic treatment regimens. However, when recurrence scores were ≥26, there was a statistically-significant difference in overall survival between systemic treatment regimens (p < 0.001). 5-year overall survival was highest (97.4%) for patients receiving triple therapy (anti-HER2 with chemotherapy and endocrine therapy), followed by those receiving dual therapy with endocrine and anti-HER2 (96.7%), and endocrine with chemotherapy (94.9%). Patients receiving endocrine therapy alone exhibited the lowest 5-year overall survival (88.5%). RESULTS: Analysis from this large national cancer registry suggests that multigene testing may have predictive value in treatment selection for patients with early-stage, HR+/HER2+ breast cancer. Prospective trials are warranted to identify subgroups of patients with HR+/HER2+ breast cancer who can be spared anti-HER2 treatments and cytotoxic chemotherapy. Elsevier 2022-09-06 /pmc/articles/PMC9493134/ /pubmed/36137495 http://dx.doi.org/10.1016/j.breast.2022.09.002 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Bilani, Nadeem
Crowley, Fionnuala
Mohanna, Mohamed
Itani, Mira
Yaghi, Marita
Saravia, Diana
Jabbal, Iktej
Dominguez, Barbara
Liang, Hong
Nahleh, Zeina
Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer?
title Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer?
title_full Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer?
title_fullStr Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer?
title_full_unstemmed Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer?
title_short Does the 21-gene recurrence score have clinical utility in HR+/HER2+ breast cancer?
title_sort does the 21-gene recurrence score have clinical utility in hr+/her2+ breast cancer?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9493134/
https://www.ncbi.nlm.nih.gov/pubmed/36137495
http://dx.doi.org/10.1016/j.breast.2022.09.002
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