Journal Article
. 2013 Dec;25(2).
doi: 10.1093/annonc/mdt494.

Predicting distant recurrence in receptor-positive breast cancer patients with limited clinicopathological risk: using the PAM50 Risk of Recurrence score in 1478 postmenopausal patients of the ABCSG-8 trial treated with adjuvant endocrine therapy alone

M Gnant 1 M Filipits  R Greil  H Stoeger  M Rudas  Z Bago-Horvath  B Mlineritsch  W Kwasny  M Knauer  C Singer  R Jakesz  P Dubsky  F Fitzal  R Bartsch  G Steger  M Balic  S Ressler  J W Cowens  J Storhoff  S Ferree  C Schaper  S Liu  C Fesl  T O Nielsen  Austrian Breast and Colorectal Cancer Study Group  
Affiliations
  • PMID: 24347518
  •     107 citations

Abstract

Background: PAM50 is a 50-gene test that is designed to identify intrinsic breast cancer subtypes and generate a Risk of Recurrence (ROR) score. It has been developed to be carried out in qualified routine hospital pathology laboratories.

Patients And Methods: One thousand four hundred seventy-eight postmenopausal women with estrogen receptor (ER)+ early breast cancer (EBC) treated with tamoxifen or tamoxifen followed by anastrozole from the prospective randomized ABCSG-8 trial were entered into this study. Patients did not receive adjuvant chemotherapy. RNA was extracted from paraffin blocks and analyzed using the PAM50 test. Both intrinsic subtype (luminal A/B, HER2-enriched, basal-like) and ROR score were calculated. The primary analysis was designed to test whether the continuous ROR score adds prognostic value in predicting distant recurrence (DR) over and above standard clinical variables.

Results: In all tested subgroups, ROR score significantly adds prognostic information to the clinical predictor (P<0.0001). PAM50 assigns an intrinsic subtype to all cases, and the luminal A cohort had a significantly lower ROR at 10 years compared with Luminal B (P<0.0001). Significant and clinically relevant discrimination between low- and high-risk groups occurred also within all tested subgroups.

Conclusion(S): The results of the primary analysis, in combination with recently published results from the ATAC trial, constitute Level 1 evidence for clinical validity of the PAM50 test for predicting the risk of DR in postmenopausal women with ER+ EBC. A 10-year metastasis risk of <3.5% in the ROR low category makes it unlikely that additional chemotherapy would improve this outcome-this finding could help to avoid unwarranted overtreatment.

Clinical Trial Number: ABCSG 8: NCT00291759.

Keywords: Risk of Recurrence (ROR); clinical prognostic factors; early breast cancer; intrinsic subtypes; metastasis prediction; prognosis.

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Halei C Benefield, Katherine E Reeder-Hayes, +11 authors, Melissa A Troester.
JNCI Cancer Spectr, 2021 Jan 15; 5(1). PMID: 33442657    Free PMC article.
A clinical validation study of MammaPrint in hormone receptor-positive breast cancer from the Austrian Breast and Colorectal Cancer Study Group 8 (ABCSG-8) biomarker cohort.
P Dubsky, L Van't Veer, +13 authors, M Filipits.
ESMO Open, 2021 Jan 06; 6(1). PMID: 33399073    Free PMC article.
Analysis of extracellular vesicle mRNA derived from plasma using the nCounter platform.
Jillian W P Bracht, Ana Gimenez-Capitan, +5 authors, Miguel A Molina-Vila.
Sci Rep, 2021 Feb 14; 11(1). PMID: 33580122    Free PMC article.
A Phenomic Perspective on Factors Influencing Breast Cancer Treatment: Integrating Aging and Lifestyle in Blood and Tissue Biomarker Profiling.
Ainhoa Arana Echarri, Mark Beresford, +6 authors, James E Turner.
Front Immunol, 2021 Feb 19; 11. PMID: 33597950    Free PMC article.
Review.
Development and validation for research assessment of Oncotype DX® Breast Recurrence Score, EndoPredict® and Prosigna®.
Richard Buus, Zsolt Szijgyarto, +10 authors, Maggie Chon U Cheang.
NPJ Breast Cancer, 2021 Feb 14; 7(1). PMID: 33579961    Free PMC article.
Genomic Assays in Node Positive Breast Cancer Patients: A Review.
Maroun Bou Zerdan, Maryam Ibrahim, +2 authors, Hazem I Assi.
Front Oncol, 2021 Mar 06; 10. PMID: 33665165    Free PMC article.
Review.
Validation of the GenesWell BCT Score in Young Asian Women With HR+/HER2- Early Breast Cancer.
Mi Jeong Kwon, Jai Min Ryu, +12 authors, Jeong Eon Lee.
Front Oncol, 2021 Mar 13; 11. PMID: 33708625    Free PMC article.
Prognostic Cancer Gene Expression Signatures: Current Status and Challenges.
Yuquan Qian, Jimmy Daza, +4 authors, Andreas Teufel.
Cells, 2021 Apr 04; 10(3). PMID: 33804045    Free PMC article.
Review.
The microRNA analysis portal is a next-generation tool for exploring and analyzing miRNA-focused data in the literature.
Stefano Pirrò, Ivana Matic, Vittorio Colizzi, Andrea Galgani.
Sci Rep, 2021 Apr 28; 11(1). PMID: 33903708