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Br J Cancer. 2015 Apr 14;112(8):1405-10. doi: 10.1038/bjc.2015.98. Epub 2015 Mar 24.

The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial.

Author information

1
1] Hospital of the Sisters of Charity, Breast Health Center, Linz, Austria [2] Department of Surgery and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.
2
Department of Oncology, Medical University Vienna, Vienna, Austria.
3
Department of Pathology, Medical University Vienna, Vienna, Austria.
4
Department of Oncology, Salzburger Landesklinik, Salzburg, Austria.
5
Department of Pathology, Salzburger Landesklinik, Salzburg, Austria.
6
Department of Oncology, Medical University Graz, Graz, Austria.
7
Department of Pathology, Medical University Graz, Graz, Austria.
8
Department of Surgery, KH Leoben, Leoben, Austria.
9
Department of Surgery and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.
10
Sividon Diagnostics, Cologne, Germany.

Abstract

BACKGROUND:

The aim of this study was to examine whether EndoPredict (EP), a novel genomic expression test, is effective in predicting local recurrence (LR)-free survival (LRFS) following surgery for breast cancer in postmenopausal women. In addition, we examined whether EP may help tailor local therapy in these patients.

METHODS:

From January 1996 to June 2004, 3714 postmenopausal patients were randomly assigned to either tamoxifen or tamoxifen followed by anastrozole within the prospective ABCSG 8 trial. Using assay scores from EP, we classified breast tumour blocks as either low or high risk for recurrence.

RESULTS:

Data were gathered from 1324 patients. The median follow-up was 72.3 months and the cumulative incidence of LR was 2.6% (0.4% per year). The risk of LR over a 10-year period among patients with high-risk lesions (n=683) was significantly higher (LRFS=91%) when compared with patients with low-risk lesions (n=641) (10-year LRFS=97.5%) (HR: 1.31 (1.16-1.48) P<0.005). The groups that received breast conservation surgery (BCT) and mastectomy (MX) had similar LR rates (P=0.879). Radiotherapy (RT) after BCT significantly improved LRFS in the cohorts predicted by EP to be low-risk for LR (received RT: n=436, 10-year LRFS 99.8%; did not receive RT: n=63, 10-year LRFS 83.6%, P<0.005).

CONCLUSIONS:

EndoPredict is an effective prognostic tool for predicting LRFS. Among postmenopausal, low-risk patients, EP does not appear to be useful for tailoring local therapy.

PMID:
25867274
PMCID:
PMC4402462
DOI:
10.1038/bjc.2015.98
[Indexed for MEDLINE]
Free PMC Article

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