Prediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study.

2.50
Hdl Handle:
http://hdl.handle.net/10541/109047
Title:
Prediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study.
Authors:
Dowsett, Mitch; Cuzick, Jack; Wale, Chris; Forbes, John F; Mallon, Elizabeth A; Salter, Janine; Quinn, Emma; Dunbier, Anita; Baum, Michael; Buzdar, Aman; Howell, Anthony ( 0000-0002-6233-719X ) ; Bugarini, Roberto; Baehner, Frederick L; Shak, Steven
Abstract:
PURPOSE To determine whether the Recurrence Score (RS) provided independent information on risk of distant recurrence (DR) in the tamoxifen and anastrozole arms of the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trial. PATIENTS AND METHODS RNA was extracted from 1,372 tumor blocks from postmenopausal patients with hormone receptor-positive primary breast cancer in the monotherapy arms of ATAC. Twenty-one genes were assessed by quantitative reverse transcriptase polymerase chain reaction, and the RS was calculated. Cox proportional hazards models assessed the value of adding RS to a model with clinical variables (age, tumor size, grade, and treatment) in node-negative (N0) and node-positive (N+) women. RESULTS Reportable scores were available from 1,231 evaluable patients (N0, n = 872; N+, n = 306; and node status unknown, n = 53); 72, 74, and six DRs occurred in N0, N+, and node status unknown patients, respectively. For both N0 and N+ patients, RS was significantly associated with time to DR in multivariate analyses (P < .001 for N0 and P = .002 for N+). RS also showed significant prognostic value beyond that provided by Adjuvant! Online (P < .001). Nine-year DR rates in low (RS < 18), intermediate (RS = 18 to 30), and high RS (RS > or = 31) groups were 4%, 12%, and 25%, respectively, in N0 patients and 17%, 28%, and 49%, respectively, in N+ patients. The prognostic value of RS was similar in anastrozole- and tamoxifen-treated patients. CONCLUSION This study confirmed the performance of RS in postmenopausal HR+ patients treated with tamoxifen in a large contemporary population and demonstrated that RS is an independent predictor of DR in N0 and N+ hormone receptor-positive patients treated with anastrozole, adding value to estimates with standard clinicopathologic features.
Affiliation:
Royal Marsden Hospital,Wolfson Institute for Preventive Medicine, Queen Mary University of London London. mitch.dowsett@icr.ac.uk
Citation:
Prediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study. 2010, 28 (11):1829-34 J Clin Oncol
Journal:
Journal of Clinical Oncology
Issue Date:
10-Apr-2010
URI:
http://hdl.handle.net/10541/109047
DOI:
10.1200/JCO.2009.24.4798
PubMed ID:
20212256
Type:
Article
Language:
en
ISSN:
1527-7755
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorDowsett, Mitchen
dc.contributor.authorCuzick, Jacken
dc.contributor.authorWale, Chrisen
dc.contributor.authorForbes, John Fen
dc.contributor.authorMallon, Elizabeth Aen
dc.contributor.authorSalter, Janineen
dc.contributor.authorQuinn, Emmaen
dc.contributor.authorDunbier, Anitaen
dc.contributor.authorBaum, Michaelen
dc.contributor.authorBuzdar, Amanen
dc.contributor.authorHowell, Anthonyen
dc.contributor.authorBugarini, Robertoen
dc.contributor.authorBaehner, Frederick Len
dc.contributor.authorShak, Stevenen
dc.date.accessioned2010-08-04T11:59:49Z-
dc.date.available2010-08-04T11:59:49Z-
dc.date.issued2010-04-10-
dc.identifier.citationPrediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study. 2010, 28 (11):1829-34 J Clin Oncolen
dc.identifier.issn1527-7755-
dc.identifier.pmid20212256-
dc.identifier.doi10.1200/JCO.2009.24.4798-
dc.identifier.urihttp://hdl.handle.net/10541/109047-
dc.description.abstractPURPOSE To determine whether the Recurrence Score (RS) provided independent information on risk of distant recurrence (DR) in the tamoxifen and anastrozole arms of the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trial. PATIENTS AND METHODS RNA was extracted from 1,372 tumor blocks from postmenopausal patients with hormone receptor-positive primary breast cancer in the monotherapy arms of ATAC. Twenty-one genes were assessed by quantitative reverse transcriptase polymerase chain reaction, and the RS was calculated. Cox proportional hazards models assessed the value of adding RS to a model with clinical variables (age, tumor size, grade, and treatment) in node-negative (N0) and node-positive (N+) women. RESULTS Reportable scores were available from 1,231 evaluable patients (N0, n = 872; N+, n = 306; and node status unknown, n = 53); 72, 74, and six DRs occurred in N0, N+, and node status unknown patients, respectively. For both N0 and N+ patients, RS was significantly associated with time to DR in multivariate analyses (P < .001 for N0 and P = .002 for N+). RS also showed significant prognostic value beyond that provided by Adjuvant! Online (P < .001). Nine-year DR rates in low (RS < 18), intermediate (RS = 18 to 30), and high RS (RS > or = 31) groups were 4%, 12%, and 25%, respectively, in N0 patients and 17%, 28%, and 49%, respectively, in N+ patients. The prognostic value of RS was similar in anastrozole- and tamoxifen-treated patients. CONCLUSION This study confirmed the performance of RS in postmenopausal HR+ patients treated with tamoxifen in a large contemporary population and demonstrated that RS is an independent predictor of DR in N0 and N+ hormone receptor-positive patients treated with anastrozole, adding value to estimates with standard clinicopathologic features.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectCancer Recurrenceen
dc.subjectBiological Tumour Markersen
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBreast Neoplasms-
dc.subject.meshChemotherapy, Adjuvant-
dc.subject.meshFemale-
dc.subject.meshGenetic Testing-
dc.subject.meshHumans-
dc.subject.meshLymph Nodes-
dc.subject.meshNeoplasm Recurrence, Local-
dc.subject.meshNitriles-
dc.subject.meshPostmenopause-
dc.subject.meshRisk Factors-
dc.subject.meshSurvival Rate-
dc.subject.meshTamoxifen-
dc.subject.meshTreatment Outcome-
dc.subject.meshTriazoles-
dc.subject.meshTumor Markers, Biological-
dc.titlePrediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study.en
dc.typeArticleen
dc.contributor.departmentRoyal Marsden Hospital,Wolfson Institute for Preventive Medicine, Queen Mary University of London London. mitch.dowsett@icr.ac.uken
dc.identifier.journalJournal of Clinical Oncologyen

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