TY - JOUR
T1 - Validation of the 21-gene test as a predictor of clinical response to neoadjuvant hormonal therapy for ER+, HER2-negative breast cancer
T2 - the TransNEOS study
AU - Iwata, Hiroji
AU - Masuda, Norikazu
AU - Yamamoto, Yutaka
AU - Fujisawa, Tomomi
AU - Toyama, Tatsuya
AU - Kashiwaba, Masahiro
AU - Ohtani, Shoichiro
AU - Taira, Naruto
AU - Sakai, Takehiko
AU - Hasegawa, Yoshie
AU - Nakamura, Rikiya
AU - Akabane, Hiromitsu
AU - Shibahara, Yukiko
AU - Sasano, Hironobu
AU - Yamaguchi, Takuhiro
AU - Sakamaki, Kentaro
AU - Bailey, Helen
AU - Cherbavaz, Diana B.
AU - Jakubowski, Debbie M.
AU - Sugiyama, Naoko
AU - Chao, Calvin
AU - Ohashi, Yasuo
N1 - Funding Information:
Funding Genomic Health provided the Recurrence Score tests for the TransNEOS study, including shipping costs. The parent NEOS study was sponsored by CSPOR (Comprehensive Support Project for Oncology Research), part of a public health research foundation. Novartis and Chugai Pharmaceuticals provided funding to CSPOR.
Publisher Copyright:
© 2018, The Author(s).
PY - 2019/1/15
Y1 - 2019/1/15
N2 - Purpose: The Recurrence Score test is validated to predict benefit of adjuvant chemotherapy. TransNEOS, a translational study of New Primary Endocrine-therapy Origination Study (NEOS), evaluated whether Recurrence Score results can predict clinical response to neoadjuvant letrozole. Methods: NEOS is a phase 3 clinical trial of hormonal therapy ± adjuvant chemotherapy for postmenopausal patients with ER+, HER2-negative, clinically node-negative breast cancer, after six months of neoadjuvant letrozole and breast surgery. TransNEOS patients had tumors ≥ 2 cm and archived core-biopsy samples taken before neoadjuvant letrozole and subsequently sent for Recurrence Score testing. The primary endpoint was to evaluate clinical (complete or partial) response to neoadjuvant letrozole for RS < 18 versus RS ≥ 31. Secondary endpoints included evaluation of clinical response and rate of breast-conserving surgery (BCS) by continuous Recurrence Score result, ESR1 and PGR single-gene scores, and ER gene-group score. Results: Of 295 TransNEOS patients (median age 63 years; median tumor size 25 mm; 66% grade 1), 53.2% had RS < 18, 28.5% had RS18–30, and 18.3% had RS ≥ 31. Clinical response rates were 54% (RS < 18), 42% (RS18–30), and 22% (RS ≥ 31). A higher proportion of patients with RS < 18 had clinical responses (p < 0.001 vs. RS ≥ 31). In multivariable analyses, continuous Recurrence Score result (p < 0.001), ESR1 score (p = 0.049), PGR score (p < 0.001), and ER gene-group score (p < 0.001) were associated with clinical response. Recurrence Score group was significantly associated with rate of BCS after neoadjuvant treatment (RS < 18 vs. RS ≥ 31, p = 0.010). Conclusion: The Recurrence Score test is validated to predict clinical response to neoadjuvant letrozole in postmenopausal patients with ER+, HER2-negative, clinically node-negative breast cancer.
AB - Purpose: The Recurrence Score test is validated to predict benefit of adjuvant chemotherapy. TransNEOS, a translational study of New Primary Endocrine-therapy Origination Study (NEOS), evaluated whether Recurrence Score results can predict clinical response to neoadjuvant letrozole. Methods: NEOS is a phase 3 clinical trial of hormonal therapy ± adjuvant chemotherapy for postmenopausal patients with ER+, HER2-negative, clinically node-negative breast cancer, after six months of neoadjuvant letrozole and breast surgery. TransNEOS patients had tumors ≥ 2 cm and archived core-biopsy samples taken before neoadjuvant letrozole and subsequently sent for Recurrence Score testing. The primary endpoint was to evaluate clinical (complete or partial) response to neoadjuvant letrozole for RS < 18 versus RS ≥ 31. Secondary endpoints included evaluation of clinical response and rate of breast-conserving surgery (BCS) by continuous Recurrence Score result, ESR1 and PGR single-gene scores, and ER gene-group score. Results: Of 295 TransNEOS patients (median age 63 years; median tumor size 25 mm; 66% grade 1), 53.2% had RS < 18, 28.5% had RS18–30, and 18.3% had RS ≥ 31. Clinical response rates were 54% (RS < 18), 42% (RS18–30), and 22% (RS ≥ 31). A higher proportion of patients with RS < 18 had clinical responses (p < 0.001 vs. RS ≥ 31). In multivariable analyses, continuous Recurrence Score result (p < 0.001), ESR1 score (p = 0.049), PGR score (p < 0.001), and ER gene-group score (p < 0.001) were associated with clinical response. Recurrence Score group was significantly associated with rate of BCS after neoadjuvant treatment (RS < 18 vs. RS ≥ 31, p = 0.010). Conclusion: The Recurrence Score test is validated to predict clinical response to neoadjuvant letrozole in postmenopausal patients with ER+, HER2-negative, clinically node-negative breast cancer.
KW - Breast cancer
KW - Hormonal therapy
KW - Neoadjuvant
KW - Oncotype DX
KW - Recurrence score
UR - http://www.scopus.com/inward/record.url?scp=85054130987&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054130987&partnerID=8YFLogxK
U2 - 10.1007/s10549-018-4964-y
DO - 10.1007/s10549-018-4964-y
M3 - Article
C2 - 30242578
AN - SCOPUS:85054130987
SN - 0167-6806
VL - 173
SP - 123
EP - 133
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 1
ER -
