Breast Medical Oncologists' Use of Standard Prognostic Factors to Predict a 21-Gene Recurrence Score

Kamal, Arif H.; Loprinzi, Charles L.; Reynolds, Carol; Dueck, Amylou C.; Geiger, Xochiquetzal J.; Ingle, James N.; Carlson, R. W.; Hobday, Timothy J.; Winer, Eric P.; Goetz, Matthew P.

doi:10.1634/theoncologist.2011-0048

Cited by 23 publications

(15 citation statements)

References 21 publications

(18 reference statements)

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“…These findings are consistent with those reported in other retrospective and prospective studies conducted in different regions of the world (European countries, Japan, Australia and the United States), [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and highlight the consistency of the impact of knowing the Recurrence Score result on adjuvant treatment decisions between regions and countries, despite variability in health care systems and treatment practices.…”

Section: Discussionsupporting

confidence: 89%

“…Of the 47 patients in our cohort, 25 (53.2%), 19 (40.4%) and 3 (6.4%) had a low (<18), intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) …”

Section: Recurrence Score and Risk Assessment By The St Gallen Criteriamentioning

confidence: 85%

“…Overall, in more than one-third of patients, adjuvant treatment recommendations were changed after Oncotype DX testing, mostly from chemoendocrine therapy to endocrine therapy alone, but also from endocrine therapy alone to chemoendocrine therapy. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Notably, data on the impact of the Recurrence Score results on adjuvant treatment recommendations in Middle Eastern countries are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Oncotype DX testing on adjuvant treatment decisions in patients with early breast cancer: A single-center study in the United Arab Emirates

Jaafar

Bashir

Taher

et al. 2014

Asia-Pac J Clin Oncol

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Section: Discussionsupporting

confidence: 89%

“…Of the 47 patients in our cohort, 25 (53.2%), 19 (40.4%) and 3 (6.4%) had a low (<18), intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) …”

Section: Recurrence Score and Risk Assessment By The St Gallen Criteriamentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Impact of Oncotype DX testing on adjuvant treatment decisions in patients with early breast cancer: A single-center study in the United Arab Emirates

Jaafar

Bashir

Taher

et al. 2014

Asia-Pac J Clin Oncol

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“…A study exploring the ability of oncologists to predict the RS using standard prognostic criteria revealed that oncologists are able to differentiate between a low or intermediate RS and a high RS using standard prognostic criteria [12]. However, in this study, provision of the actual RS changed the treatment recommendations in nearly 20% of cases, most often in intermediate-risk cases, suggesting that the RS may reduce chemotherapy use [12].…”

Section: Discussionmentioning

confidence: 82%

“…However, in this study, provision of the actual RS changed the treatment recommendations in nearly 20% of cases, most often in intermediate-risk cases, suggesting that the RS may reduce chemotherapy use [12]. Another study looking at the ability of oncologists to estimate recurrence risk also showed that specialists tend to overestimate the risk of recurrence compared with RS, resulting in potential significant overtreatment of breast cancer patients with adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 94%

Estimating the OncotypeDX score: validation of an inexpensive estimation tool

Eaton

Pesce

Murphy

et al. 2016

Breast Cancer Res Treat

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Background OncotypeDX, a multi-gene expression assay, has been incorporated into clinical practice as a prognostic and predictive tool. However, its use in resource-constrained international healthcare systems is limited. Here we develop and validate a simplified model using clinicopathologic criteria to predict OncotypeDX score. Methods Patients with estrogen receptor (ER) and/or progesterone receptor (PR) positive and HER2 negative invasive ductal carcinoma for whom the OncotypeDX test was successfully performed between 09/2008–12/2011 were retrospectively identified. Tumor size, nuclear and histologic grade, lymphovascular invasion, and ER and PR status were extracted from pathology reports. Data were split into a training dataset comprising women tested 09/2008–04/2011, and a validation dataset comprising women tested 04/2011–12/2011. Using the training dataset, linear regression analysis was used to identify factors associated with OncotypeDX score, and to create a simplified risk score and identify risk cutoffs. Results Estrogen and progesterone receptors, tumor size, nuclear and histologic grades, and lymphovascular involvement were independently associated with OncotypeDX. The full model explained 39% of the variation in the test data, and the simplified risk score and cutoffs assigned 57% of patients in the test data to the correct risk category (OncotypeDX score <18, 18–30, >30). 41% of patients were predicted to have OncotypeDX score<18; of these, 83%, 16%, and 2% had true scores of <18, 18–30, and >30, respectively. Conclusions Awaiting an inexpensive test that is prognostic and predictive, our simplified tool allows clinicians to identify a fairly large group of patients (41%) with very low chance of having high-risk disease (2%).

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Ki‐67 index, progesterone receptor expression, histologic grade and tumor size in predicting breast cancer recurrence risk: A consecutive cohort study

Zhang

Zhou

Mao

et al. 2020

Cancer Communications

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Background:The 21-gene recurrence score (RS) assay has been recommended by major guidelines for treatment decision in hormone receptor (HR)-positive early breast cancer (EBC). However, the genomic assay is not accessible and affordable worldwide. Alternatively, an increasing number of studies have shown that traditional immunohistochemistry (IHC) can partially or even completely replace the role of the 21-gene genomic assay. Here, we developed and validated a predictive model (IHC3 model) combining the Ki-67 index, progesterone receptor (PR) expression, histologic grade, and tumor size to predict the recurrence risk of HR-positive EBC. Methods: The data from 389 patients (development set) with HR-positive, human epidermal growth factor receptor 2-negative, lymph node non-metastasized invasive breast cancer were used to construct the IHC3 model based on the Surexam ® 21gene RS and the TAILORx clinical trial criteria. An additional 146 patients with the same characteristics constituted the validation set. The predictive accuracy of the IHC3 model was compared with that of Orucevic et al.'s nomogram. Invasive diseasefree survival (IDFS) was analyzed in the IHC3 predictive low-recurrence risk (pLR) group and the predictive high-recurrence risk (pHR) group. The Pearson chi-square test, Fisher exact test, and log-rank test were used for analysis. Results: The pLR and pHR group could be easily stratified using the decision tree model without network dependence. The accuracies of the IHC3 model were 86.1% in the development set and 87.7% in the validation set. The predictive accuracy of the IHC3 model and Orucevic et al.'s nomogram for the whole cohort was 86.5% and 86.9%, respectively. After a 52-month of median follow-up, a significant difference Abbreviations: ALND, axillary lymph node dissection; CART, classification and regression trees; EBC, early breast cancer; ER, estrogen receptor; FISH, fluorescence in situ hybridization; HER2, human epidermal growth factor receptor 2; HR, hormone receptor; IDC, invasive ductal carcinoma; IDFS, invasive disease-free survival; IHC, immunohistochemistry; ILC, invasive lobular carcinoma; NPV, negative predictive value; pHR, predictive high-recurrence risk; pLR, predictive low-recurrence risk; PPV, positive predictive value; PR, progesterone receptor; RS, recurrence score; SERM, selective estrogen receptor modulator; SLNB, sentinel lymph node biopsy.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Breast Medical Oncologists' Use of Standard Prognostic Factors to Predict a 21-Gene Recurrence Score

Cited by 23 publications

References 21 publications

Impact of Oncotype DX testing on adjuvant treatment decisions in patients with early breast cancer: A single-center study in the United Arab Emirates

Impact of Oncotype DX testing on adjuvant treatment decisions in patients with early breast cancer: A single-center study in the United Arab Emirates

Estimating the OncotypeDX score: validation of an inexpensive estimation tool

Ki‐67 index, progesterone receptor expression, histologic grade and tumor size in predicting breast cancer recurrence risk: A consecutive cohort study

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