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'lizbeth 05-20-2014 11:03 AM

Clinical impact of differential risk stratification by breast cancer index (BCI) vers
 
I've edited slightly to make this more readable - 'lizbeth

Clinical impact of differential risk stratification by breast cancer index (BCI) versus recurrence score (RS) in HR+ early-stage breast cancer: A TransATAC study.


Abstract No:
532
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2014 ASCO Annual Meeting!


Session: Breast Cancer - HER2/ER
Type: Poster Highlights Session
Time 1: Sunday June 1, 8:00 AM to 11:00 AM
Location 1: E354b
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Time 2: Sunday June 1, 11:30 AM to 12:45 PM
Location 2: E Arie Crown Theater
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Author(s): Ivana Sestak, Yi Zhang, Catherine A. Schnabel, Brock Schroeder, Mark Erlander, Paul E. Goss, Jack M. Cuzick, Mitchell Dowsett, Dennis Sgroi; Queen Mary, University of London, London, United Kingdom; bioTheranostics, Inc., San Diego, CA; Trovagene, San Diego, CA; Massachusetts General Hospital Cancer Center, Boston, MA; Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, London, United Kingdom; The Royal Marsden NHS Foundation Trust, London, United Kingdom; Massachusetts General Hospital, The Avon Foundation, Boston, MA
Abstract Disclosures

Abstract:

Background: Breast cancer index (BCI) is a genomic signature that significantly predicts risk of both early (0-5y) and late (5-10y) distant recurrence (DR) in HR+, LN- breast cancer. Previous results from the TransATAC study showed that both breast cancer index (BCI) and Oncotype Dx RS added significant prognostic information for 10y DR risk. Here, pre-defined risk stratification with breast cancer index (BCI) vs recurrence score (RS) and its potential clinical impact were comparatively evaluated. Methods: 665 HR+, LN- patients were examined. BCI and recurrence score (RS) risk groups were determined using pre-defined clinical cut-points. Kaplan-Meier estimates of 10y risk of DR and log-rank tests were used to examine cross-stratification between breast cancer index (BCI) and recurrence score (RS). Likelihood Ratio (LR) tests were used to quantitate relative prognostic information beyond CTS. Results: breast cancer index (BCI) re-stratification of the RS-Intermediate (RS-I) and RS-Low (RS-L) groups significantly impacted risk of 10y DR (P=0.003 and P<0.001), whereas RS did not significantly re-stratify BCI risk prediction (Table). breast cancer index (BCI) identified a small subset (20 pts in RS-L) with a high risk of DR (23.3%). Furthermore, breast cancer index (BCI) identified a large (95 pts in RS-I) and smaller (34 pts in RS-I) subset with 7.1% and 27.8% 10y DR risk, respectively. BCI added significant prognostic information beyond CTS+ RS (p=0.0009), whereas recurrence score (RS) did not provide additional prognostic information beyond CTS+ breast cancer index (BCI) (p=0.1). Conclusions: In this retrospective analysis evaluating individualized risk stratification, breast cancer index (BCI) identified subsets of RS-L and RS-I LN- patients with significant and clinically distinct rates of DR. Breast cancer index (BCI) identified a small subset of RS-L and RS-I LN- patients that would potentially benefit from additional therapy.

<table class="mtgabstract"><caption class="mtgabstract-table-title">Risk stratification and 10-year distant recurrence rates (%).</caption> <thead class="mtgabstract"> <tr> <th class="align-left" colspan="2" rowspan="2">No. of patients
</th> <th class="border-bottom-broken align-middle" colspan="3">BCI risk groups<hr></th> </tr> <tr> <th class="border-bottom">Low</th> <th class="border-bottom">Inter</th> <th class="border-bottom">High</th> <th class="border-bottom">Total</th> <th class="border-bottom">P value</th> </tr> </thead> <tbody> <tr> <td class="row-heading">RS risk groups</td> <td>Low</td> <td>283
(3.9%)</td> <td>85
(12.2%)</td> <td>20
(23.3%)</td> <td>388
(6.6%)</td> <td><0.001</td> </tr> <tr> <td class="row-heading">
</td> <td>Inter</td> <td>95
(7.1%)</td> <td>49
(24.3%)</td> <td>34
(27.8%)</td> <td>178
(15.8%)</td> <td>0.003</td> </tr> <tr> <td class="row-heading">
</td> <td>High</td> <td>12
(10%)</td> <td>32
(25.4%)</td> <td>55
(31.5%)</td> <td>99
(26.9%)</td> <td>0.2 </td> </tr> <tr> <td class="row-heading">
</td> <td>Total</td> <td>390
(4.8%)</td> <td>166
(18.3%)</td> <td>109
(29.0%)</td> <td>665</td> <td>
</td> </tr> <tr> <td class="row-heading">
</td> <td>P value</td> <td>0.4</td> <td>0.07</td> <td>0.6</td> <td>
</td></tr></tbody></table>


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