The 70-gene prognosis-signature predicts disease outcome in breast cancer patients with 1–3 positive lymph nodes in an independent validation study

Mook, Stella; Schmidt, Marjanka K.; Viale, Giuseppe; Pruneri, Giancarlo; Eekhout, I.; Floore, Arno; Glas, Annuska M.; Bogaerts, Jan; Cardoso, Fátima; Piccart‐Gebhart, Martine; Rutgers, Ejt; Veer, Laura J. van’t

doi:10.1007/s10549-008-0130-2

Cited by 261 publications

(160 citation statements)

References 20 publications

(37 reference statements)

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“…The prognostic value of 70-gene profile has been validated in a range of series of patients [3][4][5][6]. These studies confirmed that the 70-gene signature accurately discriminates between patients at high risk of distant metastasis and death and patients with a favorable prognosis.…”

Section: Introductionmentioning

confidence: 64%

The 70-gene signature as a response predictor for neoadjuvant chemotherapy in breast cancer

Straver

Glas

Hannemann

et al. 2009

Breast Cancer Res Treat

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224

118

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Section: Introductionmentioning

confidence: 64%

The 70-gene signature as a response predictor for neoadjuvant chemotherapy in breast cancer

Straver

Glas

Hannemann

et al. 2009

Breast Cancer Res Treat

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224

118

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“…Although axillary lymph node status is an important prognostic factor, 25 -30% of node-positive patients remain free of distant metastasis. Mook et al [16] have demonstrated that the 70-gene signature can predict disease outcome in breast cancer patients with 1 -3 positive lymph nodes. The conclusion was that MammaPrint accurately identifies patients with an excellent disease outcome in node-positive breast cancer, who may be safely spared adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

MammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast cancer

et al. 2013

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Corresponding author: M J Kotze (maritha@sun.ac.za)Background. Clinical and pathological parameters may overestimate the need for chemotherapy in patients with early-stage breast cancer. More accurate determination of the risk of distant recurrence is now possible with use of genetic tests, such as the 70-gene MammaPrint profile. Objectives. A health technology assessment performed by a medical insurer in 2009 introduced a set of test eligibility criteria -the MammaPrint Pre-screen Algorithm (MPA) -applied in this study to determine the clinical usefulness of a pathology-supported genetic testing strategy, aimed at the reduction of healthcare costs.Methods. An implementation study was designed to take advantage of the fact that the 70-gene profile excludes analysis of hormone receptor and human epidermal growth factor receptor 2 (HER2) status, which form part of the MPA based partly on immunohistochemistry routinely performed in all breast cancer patients. The study population consisted of 104 South African women with early-stage breast carcinoma referred for MammaPrint. For the MammaPrint test, RNA was extracted from 60 fresh tumours (in 58 patients) and 46 formalin-fixed, paraffin-embedded (FFPE) tissue samples. Results. When applying the MPA for selection of patients eligible for MammaPrint testing, 95 of the 104 patients qualified. In this subgroup 62% (59/95) were classified as low risk. Similar distribution patterns for risk classification were obtained for RNA extracted from fresh tumours v. FFPE tissue samples. Conclusions. The 70-gene profile classifies approximately 40% of early-stage breast cancer patients as low-risk compared with 15% using conventional criteria. In comparison, more than 60% were shown to be low risk with use of the MPA validated in this study as an appropriate strategy to prevent chemotherapy overtreatment in patients with early-stage breast cancer.

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“…In the whole patient population, 90% of patients were estrogen receptor (ER) positive and 69% of the study patients were progesterone receptor (PR) positive. The studies by van de Vijver et al [6], Bueno-deMesquita et al [14,16], Mook et al [17,18] …”

Section: Patientsmentioning

confidence: 99%

The predictive value of the 70-gene signature for adjuvant chemotherapy in early breast cancer

Knauer

Mook

Rutgers

et al. 2010

Breast Cancer Res Treat

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234

131

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International audienceMultigene assays have been developed and validated to determine the prognosis of breast cancer. In this study, we assessed the additional predictive value of the 70-gene MammaPrint signature for chemotherapy (CT) benefit in addition to endocrine therapy (ET) from pooled study series. For 541 patients who received either ET ( = 315) or ET + CT ( = 226), breast cancer-specific survival (BCSS) and distant disease-free survival (DDFS) at 5 years were assessed separately for the 70-gene high and low risk groups. The 70-gene signature classified 252 patients (47%) as low risk and 289 (53%) as high risk. Within the 70-gene low risk group, BCSS was 97% for the ET group and 99% for the ET + CT group at 5 years with a non-significant univariate hazard ratio (HR) of 0.58 (95% CI 0.07–4.98; = 0.62). In the 70-gene high risk group, BCSS was 81% (ET group) and 94% (ET + CT group) at 5 years with a significant HR of 0.21 (95% CI 0.07–0.59; < 0.01). DDFS was 93% (ET) versus 99% (ET + CT), respectively, in the 70-gene low risk group, HR 0.26 (95% CI 0.03–2.02; = 0.20). In the high risk group DDFS was 76 versus 88%, HR of 0.35 (95% CI 0.17–0.71; < 0.01). Results were similar in multivariate analysis, showing significant survival benefit by adding CT in the 70-gene high risk group. A significant and clinically meaningful benefit was observed by adding chemotherapy to endocrine treatment in 70-gene high risk patients. This benefit was not significant in low risk patients, who were at such low risk for recurrence and cancer-related death, that adding CT does not appear to be clinically meaningful

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The 70-gene prognosis-signature predicts disease outcome in breast cancer patients with 1–3 positive lymph nodes in an independent validation study

Cited by 261 publications

References 20 publications

The 70-gene signature as a response predictor for neoadjuvant chemotherapy in breast cancer

The 70-gene signature as a response predictor for neoadjuvant chemotherapy in breast cancer

MammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast cancer

The predictive value of the 70-gene signature for adjuvant chemotherapy in early breast cancer

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