A new molecular prognostic score for predicting the risk of distant metastasis in patients with HR+/HER2- early breast cancer

Gyungyub Gong ¹, Mi Jeong Kwon ², Jinil Han ³, Hee Jin Lee ¹, Se Kyung Lee ⁴, Jeong Eon Lee ⁴, Seon-Heui Lee ⁵, Sarah Park ⁶, Jong-Sun Choi ⁶, Soo Youn Cho ⁷, Sei Hyun Ahn ⁸, Jong Won Lee ⁸, Sang Rae Cho ³, Youngho Moon ³, Byung-Ho Nam ⁹, Seok Jin Nam ⁴, Yoon-La Choi ⁷, Young Kee Shin ⁶

Affiliations

¹ Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, Korea.
² College of Pharmacy, Kyungpook National University, Daegu, 41566, Korea.
³ Gencurix, Inc., Seoul, 08394, Korea.
⁴ Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.
⁵ Department of Nursing Science, College of Nursing, Gachon University, Incheon, 21936, Korea.
⁶ The Center for Anti-cancer Companion Diagnostics, Bio-MAX/N-Bio, Seoul National University, Seoul, 08826, Korea.
⁷ Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.
⁸ Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, Korea.
⁹ Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Korea.

PMID: 28350001
47 References
9 citations

Abstract

To make an optimal treatment decision for early stage breast cancer, it is important to identify risk of recurrence. Here, we developed and validated a new prognostic model for predicting the risk of distant metastasis in patients with pN0-N1, hormone receptor-positive, HER2-negative (HR+/HER2-) breast cancer treated with hormone therapy alone. RNA was extracted from formalin-fixed, paraffin-embedded tumor tissues and gene expression was measured by quantitative real-time reverse transcription-PCR. The relative expression of six novel prognostic genes was combined with two clinical variables (nodal status and tumor size) to calculate a risk score (BCT score). In the validation cohort treated with hormone therapy alone, the 10 year rate of distant metastasis in the high-risk group (26.3%) according to BCT score was significantly higher than that in the low-risk group (3.8%) (P < 0.001). Multivariate analysis adjusted for clinical variables revealed that BCT score is an independent predictor of distant metastasis. Moreover, the C-index estimate revealed that BCT score has a prognostic power superior to that of prognostic models based on clinicopathological parameters. The BCT score outperforms prognostic models based on traditional clinicopathological factors and predicts the risk of distant metastasis in patients with HR+/HER2- early breast cancer.

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