Journal Article
. 2018 Nov;13(11).
doi: 10.1371/journal.pone.0207155.

BCT score predicts chemotherapy benefit in Asian patients with hormone receptor-positive, HER2-negative, lymph node-negative breast cancer

Mi Jeong Kwon 1 Sae Byul Lee 2 Jinil Han 3 Jeong Eon Lee 4 Jong Won Lee 2 Gyungyub Gong 5 Peter D Beitsch 6 Seok Jin Nam 7 Sei Hyun Ahn 2 Byung-Ho Nam 8 Young Kee Shin 9 
Affiliations
  • PMID: 30462685
  •     17 References
  •     5 citations

Abstract

The Breast Cancer Test (BCT) score has been validated for its ability to predict the risk of distant metastasis in hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer. This study aimed to examine the value of the BCT score for predicting the benefit of adjuvant chemotherapy for Korean women with hormone receptor-positive, HER2-negative, lymph node-negative breast cancer. The study included 346 patients treated with either hormone therapy alone (n = 203) or hormone therapy plus chemotherapy (n = 143), and compared patient survival between the two treatment groups. The effect of BCT score on patient survival by treatment group was assessed using Cox proportional hazards models. Based on the results, the BCT score was prognostic for distant metastasis-free survival and breast cancer-specific survival in the hormone therapy alone group. There was no significant difference between the treatment groups in terms of 10-year distant metastasis-free survival in the overall patient population. However, when patients were classified as low risk (n = 266) and high risk (n = 80) according to the BCT score, addition of adjuvant chemotherapy to hormone therapy for patients classified as BCT high-risk group led to a significant improvement in 10-year distant metastasis-free survival, from 65.4% to 91.9% (hazard ratio, 0.18; 95% confidence interval, 0.05-0.64; P = 0.003); in contrast, there was no benefit for the BCT low-risk group. The stratification of patients according to the BCT score also identified clinically high-risk patients who may not benefit from chemotherapy. Results were similar for breast cancer-specific survival. In conclusion, the BCT score was not only of prognostic value but was also a predictor of chemotherapy benefit for Korean patients with hormone receptor-positive, HER2-negative, lymph node-negative breast cancer.

Estrogen receptor status by immunohistochemistry is superior to the ligand-binding assay for predicting response to adjuvant endocrine therapy in breast cancer.
J M Harvey, G M Clark, C K Osborne, D C Allred.
J Clin Oncol, 1999 May 20; 17(5). PMID: 10334533
Highly Cited.
Tailoring therapies--improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015.
A S Coates, E P Winer, +6 authors, Panel Members.
Ann Oncol, 2015 May 06; 26(8). PMID: 25939896    Free PMC article.
Highly Cited.
Multigene prognostic tests in breast cancer: past, present, future.
Balázs Győrffy, Christos Hatzis, +3 authors, Lajos Pusztai.
Breast Cancer Res, 2015 Apr 08; 17. PMID: 25848861    Free PMC article.
Highly Cited. Review.
21-Gene recurrence scores: racial differences in testing, scores, treatment, and outcome.
Mary Jo Lund, Marina Mosunjac, +7 authors, Ruth M O'Regan.
Cancer, 2011 Jul 02; 118(3). PMID: 21720988
Development of the 21-gene assay and its application in clinical practice and clinical trials.
Joseph A Sparano, Soonmyung Paik.
J Clin Oncol, 2008 Feb 09; 26(5). PMID: 18258979
Highly Cited. Review.
70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer.
Fatima Cardoso, Laura J van't Veer, +32 authors, MINDACT Investigators.
N Engl J Med, 2016 Aug 25; 375(8). PMID: 27557300
Highly Cited.
Prognostic and predictive biomarkers in breast cancer: Past, present and future.
Andrea Nicolini, Paola Ferrari, Michael J Duffy.
Semin Cancer Biol, 2017 Sep 09; 52(Pt 1). PMID: 28882552
Highly Cited. Review.
Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer.
Soonmyung Paik, Gong Tang, +11 authors, Norman Wolmark.
J Clin Oncol, 2006 May 25; 24(23). PMID: 16720680
Highly Cited.
Population-based validation of the prognostic model ADJUVANT! for early breast cancer.
Ivo A Olivotto, Chris D Bajdik, +6 authors, Karen A Gelmon.
J Clin Oncol, 2005 Apr 20; 23(12). PMID: 15837986
Highly Cited.
Triple-negative, basal-like, and quintuple-negative breast cancers: better prediction model for survival.
Yoon-La Choi, Ensel Oh, +12 authors, Young Kee Shin.
BMC Cancer, 2010 Sep 24; 10. PMID: 20860845    Free PMC article.
The predictive value of the 70-gene signature for adjuvant chemotherapy in early breast cancer.
Michael Knauer, Stella Mook, +7 authors, Laura J van 't Veer.
Breast Cancer Res Treat, 2010 Mar 06; 120(3). PMID: 20204499
Racial Differences in 21-Gene Recurrence Scores Among Patients With Hormone Receptor-Positive, Node-Negative Breast Cancer.
Andreana N Holowatyj, Michele L Cote, +5 authors, Kristen S Purrington.
J Clin Oncol, 2018 Jan 18; 36(7). PMID: 29341832    Free PMC article.
Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial.
Kathy S Albain, William E Barlow, +20 authors, Breast Cancer Intergroup of North America.
Lancet Oncol, 2009 Dec 17; 11(1). PMID: 20005174    Free PMC article.
Highly Cited.
Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer.
P M Ravdin, L A Siminoff, +4 authors, H L Parker.
J Clin Oncol, 2001 Feb 22; 19(4). PMID: 11181660
Highly Cited.
A new molecular prognostic score for predicting the risk of distant metastasis in patients with HR+/HER2- early breast cancer.
Gyungyub Gong, Mi Jeong Kwon, +15 authors, Young Kee Shin.
Sci Rep, 2017 Mar 30; 7. PMID: 28350001    Free PMC article.
The 70-gene prognostic signature for korean breast cancer patients.
Kuk Young Na, Ku Sang Kim, +7 authors, Yong Sik Jung.
J Breast Cancer, 2011 Aug 19; 14(1). PMID: 21847392    Free PMC article.
Prospective Validation of a 21-Gene Expression Assay in Breast Cancer.
Joseph A Sparano, Robert J Gray, +28 authors, George W Sledge.
N Engl J Med, 2015 Sep 29; 373(21). PMID: 26412349    Free PMC article.
Highly Cited.
High expression of NR1D1 is associated with good prognosis in triple-negative breast cancer patients treated with chemotherapy.
Hyelin Na, Jinil Han, +4 authors, Mi-Ock Lee.
Breast Cancer Res, 2019 Nov 30; 21(1). PMID: 31779659    Free PMC article.
Clinical Validation of BCT Scores With Prognostic Factors in Hormone Receptor-positive, HER2-negative Early Breast Cancer.
Jeeyeon Lee, Won Hwa Kim, +9 authors, Ho Yong Park.
In Vivo, 2019 Oct 31; 33(6). PMID: 31662548    Free PMC article.
UBE2C Overexpression Aggravates Patient Outcome by Promoting Estrogen-Dependent/Independent Cell Proliferation in Early Hormone Receptor-Positive and HER2-Negative Breast Cancer.
Yu-Jin Kim, Gyunghwa Lee, +4 authors, Young Kee Shin.
Front Oncol, 2020 Feb 11; 9. PMID: 32039034    Free PMC article.
Comparison of GenesWell BCT Score With Oncotype DX Recurrence Score for Risk Classification in Asian Women With Hormone Receptor-Positive, HER2-Negative Early Breast Cancer.
Mi Jeong Kwon, Jeong Eon Lee, +12 authors, Young Kee Shin.
Front Oncol, 2019 Aug 14; 9. PMID: 31404265    Free PMC article.
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.