A comparative analysis of recurrence risk predictions in ER+/HER2− early breast cancer using NHS Nottingham Prognostic Index, PREDICT, and CanAssist Breast

Gunda, Aparna; Eshwaraiah, Mallikarjuna Siraganahalli; Gangappa, Kiran; Kaur, Taranjot; Bakre, Manjiri M.

doi:10.1007/s10549-022-06729-7

Cited by 3 publications

(4 citation statements)

References 38 publications

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“…Thus, this data establishes the higher utility of CAB over these online tools that primarily function through clinical parameters. This is in line with our data published recently in a much bigger cohort of ~1500 patients where we show CAB stratifies significantly more patients as LR compared to NPI 23 …”

Section: Discussionsupporting

confidence: 94%

“…This is in line with our data published recently in a much bigger cohort of ~1500 patients where we show CAB stratifies significantly more patients as LR compared to NPI. 23 IKWG 2019 guidelines do not recommend chemotherapy in low Ki67 (≤5%). CAB extends its prognostic power in these patients with a low proliferative index once again in a very useful manner.…”

Section: Discussionmentioning

confidence: 99%

“…This is in line with our data published recently in a much bigger cohort of ~1500 patients where we show CAB stratifies significantly more patients as LR compared to NPI. 23 …”

Section: Discussionmentioning

confidence: 99%

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The usefulness of CanAssist Breast over Ki67 in breast cancer recurrence risk assessment

Eshwaraiah¹,

Gunda²,

Kanakasetty

et al. 2023

Cancer Medicine

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Background: Assessment of Ki67 by immunohistochemistry (IHC) has limited utility in clinical practice owing to analytical validity issues. According to International Ki67 Working Group (IKWG) guidelines, treatment should be guided by a prognostic test in patients expressing intermediate Ki67 range, >5%-<30%. The objective of the study is to compare the prognostic performance of CanAssist Breast (CAB) with that of Ki67 across various Ki67 prognostic groups. Methods:The cohort had 1701 patients. Various risk groups were compared for the distant relapse-free interval (DRFi) derived from Kaplan-Meier survival analysis. As per IKWG, patients are categorized into three risk groups: low-risk (<5%), intermediate risk (>5%-<30%), and high-risk (>30%). CAB generates two risk groups, low and high risk based on a predefined cutoff.Results: In the total cohort, 76% of the patients were low risk (LR) by CAB as against 46% by Ki67 with a similar DRFi of 94%. In the node-negative sub-cohort, 87% were LR by CAB with a DRFi of 97% against 49% by Ki67 with a DRFi of 96%.In subgroups of patients with T1 or N1 or G2 tumors, Ki67-based risk stratification was not significant while it was significant by CAB. In the intermediate Ki67 (>5%-<30%) category up to 89% (N0 sub-cohort) were LR by CAB and the percentage of LR patients was 25% (p < 0.0001) higher compared to NPI or mAOL. In the low Ki67 (≤5%) group, up to 19% were segregated as high-risk by CAB with 86% DRFi suggesting the requirement of chemotherapy in these low Ki67 patients. Conclusion:CAB provided superior prognostic information in various Ki67 subgroups, especially in the intermediate Ki67 group.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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The usefulness of CanAssist Breast over Ki67 in breast cancer recurrence risk assessment

Eshwaraiah¹,

Gunda²,

Kanakasetty

et al. 2023

Cancer Medicine

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“…Several risk scoring methods are available to support decision-making for adjuvant therapy in breast cancer to assess which patients could be spared or would benefit from adjuvant cytotoxic therapy, to avoid over- and under-treatment, respectively. Risk scoring tools in hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative early breast cancer are either based on a combination of clinicopathological factors and immunohistochemically detected tumor markers (e.g., the Nottingham Prognostic Index [NPI] and PREDICT) [ 1 ] or involve multigene expression profiles to complement pathological assessment and provide risk classification (e.g., Oncotype DX® and MammaPrint®) [ 2 , 3 ]. Testing for risk prediction versus no testing is cost-effective and imparts both clinical and economic benefits [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Performance of a novel spectroscopy-based tool for adjuvant therapy decision-making in hormone receptor-positive breast cancer: a validation study

Coombes,

Angelou,

Al-Khalili

et al. 2024

Breast Cancer Res Treat

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Purpose Digistain Index (DI), measured using an inexpensive mid-infrared spectrometer, reflects the level of aneuploidy in unstained tissue sections and correlates with tumor grade. We investigated whether incorporating DI with other clinicopathological variables could predict outcomes in patients with early breast cancer. Methods DI was calculated in 801 patients with hormone receptor-positive, HER2-negative primary breast cancer and ≤ 3 positive lymph nodes. All patients were treated with systemic endocrine therapy and no chemotherapy. Multivariable proportional hazards modeling was used to incorporate DI with clinicopathological variables to generate the Digistain Prognostic Score (DPS). DPS was assessed for prediction of 5- and 10-year outcomes (recurrence, recurrence-free survival [RFS] and overall survival [OS]) using receiver operating characteristics and Cox proportional hazards regression models. Kaplan–Meier analysis evaluated the ability of DPS to stratify risk. Results DPS was consistently highly accurate and had negative predictive values for all three outcomes, ranging from 0.96 to 0.99 at 5 years and 0.84 to 0.95 at 10 years. DPS demonstrated statistically significant prognostic ability with significant hazard ratios (95% CI) for low- versus high-risk classification for RFS, recurrence and OS (1.80 [CI 1.31–2.48], 1.83 [1.32–2.52] and 1.77 [1.28–2.43], respectively; all P < 0.001). Conclusion DPS showed high accuracy and predictive performance, was able to stratify patients into low or high-risk, and considering its cost and rapidity, has the potential to offer clinical utility.

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Prediction of the Nottingham prognostic index and molecular subtypes of breast cancer through multimodal magnetic resonance imaging

Chen,

Yu,

Pan

et al. 2024

Magnetic Resonance Imaging

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A comparative analysis of recurrence risk predictions in ER+/HER2− early breast cancer using NHS Nottingham Prognostic Index, PREDICT, and CanAssist Breast

Cited by 3 publications

References 38 publications

The usefulness of CanAssist Breast over Ki67 in breast cancer recurrence risk assessment

The usefulness of CanAssist Breast over Ki67 in breast cancer recurrence risk assessment

Performance of a novel spectroscopy-based tool for adjuvant therapy decision-making in hormone receptor-positive breast cancer: a validation study

Prediction of the Nottingham prognostic index and molecular subtypes of breast cancer through multimodal magnetic resonance imaging

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