Journal Article
. 2014 Feb; 20(5):1298-305.
doi: 10.1158/1078-0432.CCR-13-1845.

The PAM50 risk-of-recurrence score predicts risk for late distant recurrence after endocrine therapy in postmenopausal women with endocrine-responsive early breast cancer

Martin Filipits 1 Torsten O Nielsen  Margaretha Rudas  Richard Greil  Herbert Stöger  Raimund Jakesz  Zsuzsanna Bago-Horvath  Otto Dietze  Peter Regitnig  Christine Gruber-Rossipal  Elisabeth Müller-Holzner  Christian F Singer  Brigitte Mlineritsch  Peter Dubsky  Thomas Bauernhofer  Michael Hubalek  Michael Knauer  Harald Trapl  Christian Fesl  Carl Schaper  Sean Ferree  Shuzhen Liu  J Wayne Cowens  Michael Gnant  Austrian Breast and Colorectal Cancer Study Group  
Affiliations
  • PMID: 24520097
  •     63 citations

Abstract

Purpose: To assess the prognostic value of the PAM50 risk-of-recurrence (ROR) score on late distant recurrence (beyond 5 years after diagnosis and treatment) in a large cohort of postmenopausal, endocrine-responsive breast cancer patients.

Experimental Design: The PAM50 assay was performed on formalin-fixed paraffin-embedded whole-tumor sections of patients who had been enrolled in the Austrian Breast and Colorectal Cancer Study Group Trial 8 (ABCSG-8). RNA expression levels of the PAM50 genes were determined centrally using the nCounter Dx Analysis System. Late distant recurrence-free survival (DRFS) was analyzed using Cox models adjusted for clinical and pathologic parameters.

Results: PAM50 analysis was successfully performed in 1,246 ABCSG-8 patients. PAM50 ROR score and ROR-based risk groups provided significant additional prognostic information with respect to late DRFS compared with a combined score of clinical factors alone (ROR score: ΔLRχ(2) 15.32, P < 0.001; ROR-based risk groups: ΔLRχ(2) 14.83, P < 0.001). Between years 5 and 15, we observed an absolute risk of distant recurrence of 2.4% in the low ROR-based risk group, as compared with 17.5% in the high ROR-based risk group. The DRFS differences according to the PAM50 ROR score were observed for both node-positive and node-negative disease.

Conclusion: PAM50 ROR score and ROR-based risk groups can differentiate patients with breast cancer with respect to their risk for late distant recurrence beyond what can be achieved with established clinicopathologic risk factors.

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