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Clin Cancer Res. 2014 Mar 1;20(5):1298-305. doi: 10.1158/1078-0432.CCR-13-1845. Epub 2014 Feb 11.

The PAM50 risk-of-recurrence score predicts risk for late distant recurrence after endocrine therapy in postmenopausal women with endocrine-responsive early breast cancer.

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1
Authors' Affiliations: Departments of Medicine I, Pathology, and Surgery; Department of Obstetrics and Gynecology, Comprehensive Cancer Center Vienna, Medical University of Vienna; Austrian Breast and Colorectal Cancer Study Group, Vienna; Departments of Internal Medicine III and Pathology, Paracelsus Private Medical University, Salzburg; Departments of Internal Medicine and Pathology, Medical University of Graz, Graz; Departments of Pathology and Surgery, Sisters of Charity Hospital and Cancer Center, Linz; Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck; Department of Surgery, General Hospital Baden, Baden, Austria; Myraqa, Redwood Shores, California; NanoString Technologies, Seattle, Washington; and British Columbia Cancer Agency, Vancouver, British Columbia, Canada.

Abstract

PURPOSE:

To assess the prognostic value of the PAM50 risk-of-recurrence (ROR) score on late distant recurrence (beyond 5 years after diagnosis and treatment) in a large cohort of postmenopausal, endocrine-responsive breast cancer patients.

EXPERIMENTAL DESIGN:

The PAM50 assay was performed on formalin-fixed paraffin-embedded whole-tumor sections of patients who had been enrolled in the Austrian Breast and Colorectal Cancer Study Group Trial 8 (ABCSG-8). RNA expression levels of the PAM50 genes were determined centrally using the nCounter Dx Analysis System. Late distant recurrence-free survival (DRFS) was analyzed using Cox models adjusted for clinical and pathologic parameters.

RESULTS:

PAM50 analysis was successfully performed in 1,246 ABCSG-8 patients. PAM50 ROR score and ROR-based risk groups provided significant additional prognostic information with respect to late DRFS compared with a combined score of clinical factors alone (ROR score: ΔLRχ(2) 15.32, P < 0.001; ROR-based risk groups: ΔLRχ(2) 14.83, P < 0.001). Between years 5 and 15, we observed an absolute risk of distant recurrence of 2.4% in the low ROR-based risk group, as compared with 17.5% in the high ROR-based risk group. The DRFS differences according to the PAM50 ROR score were observed for both node-positive and node-negative disease.

CONCLUSION:

PAM50 ROR score and ROR-based risk groups can differentiate patients with breast cancer with respect to their risk for late distant recurrence beyond what can be achieved with established clinicopathologic risk factors.

PMID:
24520097
DOI:
10.1158/1078-0432.CCR-13-1845
[Indexed for MEDLINE]
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