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Old 05-20-2014, 11:03 AM   #1
'lizbeth
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Post 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

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.

Risk stratification and 10-year distant recurrence rates (%).
No. of patients
BCI risk groups
Low Inter High Total P value
RS risk groups Low 283
(3.9%)
85
(12.2%)
20
(23.3%)
388
(6.6%)
<0.001

Inter 95
(7.1%)
49
(24.3%)
34
(27.8%)
178
(15.8%)
0.003

High 12
(10%)
32
(25.4%)
55
(31.5%)
99
(26.9%)
0.2 

Total 390
(4.8%)
166
(18.3%)
109
(29.0%)
665

P value 0.4 0.07 0.6
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