Journal Article
. 2020 Jun; 10:783.
doi: 10.3389/fonc.2020.00783.

DGM-CM6: A New Model to Predict Distant Recurrence Risk in Operable Endocrine-Responsive Breast Cancer

Lei Lei 1 Xiao-Jia Wang 1 Yin-Yuan Mo 2 Skye Hung-Chun Cheng 3 Yunyun Zhou 4 
Affiliations
  • PMID: 32528885
  •     39 References
  •     1 citations

Abstract

To investigate the prognostic value of DGM-CM6 (Distant Genetic Model-Clinical variable Model 6) for endocrine-responsive breast cancer (ERBC) patients, we analyzed 752 operable breast cancer patients treated in a Taiwan cancer center from 2005 to 2014. Among them, 490 ERBC patients (identified by the PAM50 or immunohistochemistry method) were classified by DGM-CM6 into low- and high-risk groups (cutoff <33 and ≥33, respectively). Significant differences were observed between the DGM-CM6 low- and high-risk groups for 10-year distant recurrence-free survival (DRFS) in both lymph node (LN)- (P < 0.05) and LN+ patients (P < 0.05). Multivariate analysis confirmed the independent strength of DGM-CM6 for the prediction of high- vs. low- risk groups for DRFS (P < 0.0001, HR: 6.76, 95% CI, 1.8-25.42) and overall survival (P = 0.01, HR: 6.06, 95% CI:1.55-23.47), respectively. In summary, DGM-CM6 may be used to classify low- and high-risk groups for 10-year distant recurrence in both LN- and LN+ ERBC patients in the Asian population. A large scale clinical trial is warranted.

Keywords: breast cancer; clinical-genomic model; distant recurrence; endocrine-responsive; prognosis.

Comparison of the Performance of 6 Prognostic Signatures for Estrogen Receptor-Positive Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial.
Ivana Sestak, Richard Buus, +9 authors, Mitch Dowsett.
JAMA Oncol, 2018 Feb 17; 4(4). PMID: 29450494    Free PMC article.
Highly Cited.
Pembrolizumab plus trastuzumab in trastuzumab-resistant, advanced, HER2-positive breast cancer (PANACEA): a single-arm, multicentre, phase 1b-2 trial.
Sherene Loi, Anita Giobbie-Hurder, +18 authors, International Breast Cancer Study Group and the Breast International Group.
Lancet Oncol, 2019 Feb 16; 20(3). PMID: 30765258
Highly Cited.
A retrospective study of breast cancer subtypes: the risk of relapse and the relations with treatments.
Yahong Wang, Quangui Yin, +5 authors, Yun Niu.
Breast Cancer Res Treat, 2011 Aug 13; 130(2). PMID: 21837481
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.
Pattern of distant recurrence according to the molecular subtypes in Korean women with breast cancer.
Hyung Seok Park, Shinhyuk Kim, +5 authors, Sang Seol Jung.
World J Surg Oncol, 2012 Jan 10; 10. PMID: 22226178    Free PMC article.
The role of cytokines in the regulation of NK cells in the tumor environment.
Gordana M Konjević, Ana M Vuletić, +2 authors, Vladimir B Jurišić.
Cytokine, 2019 Feb 21; 117. PMID: 30784898
Highly Cited. Review.
Evaluation of factors related to late recurrence--later than 10 years after the initial treatment--in primary breast cancer.
Reiki Nishimura, Tomofumi Osako, +5 authors, Nobuyuki Arima.
Oncology, 2013 Jul 23; 85(2). PMID: 23867253
OncotypeDX Recurrence Score Does Not Predict Nodal Burden in Clinically Node Negative Breast Cancer Patients.
S E Tevis, R Bassett, +14 authors, R F Hwang.
Ann Surg Oncol, 2018 Dec 18; 26(3). PMID: 30556120
Differences in Clinical Outcomes between Luminal A and B Type Breast Cancers according to the St. Gallen Consensus 2013.
Hyo Jung Ahn, Soo Jin Jung, +2 authors, Hye-Kyoung Yoon.
J Breast Cancer, 2015 Jul 15; 18(2). PMID: 26155291    Free PMC article.
Age, breast cancer subtype approximation, and local recurrence after breast-conserving therapy.
Nils D Arvold, Alphonse G Taghian, +7 authors, Jay R Harris.
J Clin Oncol, 2011 Sep 09; 29(29). PMID: 21900114    Free PMC article.
Highly Cited.
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, M Filipits, +22 authors, Austrian Breast and Colorectal Cancer Study Group.
Ann Oncol, 2013 Dec 19; 25(2). PMID: 24347518
Highly Cited.
Factors predicting late recurrence for estrogen receptor-positive breast cancer.
Ivana Sestak, Mitch Dowsett, +4 authors, Jack Cuzick.
J Natl Cancer Inst, 2013 Sep 14; 105(19). PMID: 24029245    Free PMC article.
Highly Cited.
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.
Analysis of the MammaPrint breast cancer assay in a predominantly postmenopausal cohort.
Ben S Wittner, Dennis C Sgroi, +9 authors, Sridhar Ramaswamy.
Clin Cancer Res, 2008 May 17; 14(10). PMID: 18483364    Free PMC article.
Luminal B breast cancer: molecular characterization, clinical management, and future perspectives.
Felipe Ades, Dimitrios Zardavas, +6 authors, Martine Piccart.
J Clin Oncol, 2014 Jul 23; 32(25). PMID: 25049332
Highly Cited. Review.
St. Gallen/Vienna 2017: A Brief Summary of the Consensus Discussion about Escalation and De-Escalation of Primary Breast Cancer Treatment.
Michael Gnant, Nadia Harbeck, Christoph Thomssen.
Breast Care (Basel), 2017 Jun 01; 12(2). PMID: 28559767    Free PMC article.
Highly Cited. Review.
Correlation of microarray-based breast cancer molecular subtypes and clinical outcomes: implications for treatment optimization.
Kuo-Jang Kao, Kai-Ming Chang, Hui-Chi Hsu, Andrew T Huang.
BMC Cancer, 2011 Apr 20; 11. PMID: 21501481    Free PMC article.
Highly Cited.
Clinical application of the 70-gene profile: the MINDACT trial.
Fatima Cardoso, Laura Van't Veer, +3 authors, Martine J Piccart-Gebhart.
J Clin Oncol, 2008 Feb 09; 26(5). PMID: 18258980
Highly Cited.
Factors that predict recurrence later than 5 years after initial treatment in operable breast cancer.
Pattaraporn Wangchinda, Suthinee Ithimakin.
World J Surg Oncol, 2016 Aug 26; 14(1). PMID: 27557635    Free PMC article.
The prognostic value of node status in different breast cancer subtypes.
Zheng-Jun Yang, Yue Yu, +4 authors, Xu-Chen Cao.
Oncotarget, 2016 Dec 22; 8(3). PMID: 27999188    Free PMC article.
The EndoPredict score provides prognostic information on late distant metastases in ER+/HER2- breast cancer patients.
P Dubsky, J C Brase, +18 authors, Austrian Breast and Colorectal Cancer Study Group (ABCSG).
Br J Cancer, 2013 Oct 26; 109(12). PMID: 24157828    Free PMC article.
Highly Cited.
Molecular portraits of human breast tumours.
C M Perou, T Sørlie, +15 authors, D Botstein.
Nature, 2000 Aug 30; 406(6797). PMID: 10963602
Highly Cited.
Identifying clinically relevant prognostic subgroups of postmenopausal women with node-positive hormone receptor-positive early-stage breast cancer treated with endocrine therapy: a combined analysis of ABCSG-8 and ATAC using the PAM50 risk of recurrence score and intrinsic subtype.
M Gnant, I Sestak, +14 authors, J Cuzick.
Ann Oncol, 2015 May 04; 26(8). PMID: 25935792
Prognostic value of PAM50 and risk of recurrence score in patients with early-stage breast cancer with long-term follow-up.
Hege O Ohnstad, Elin Borgen, +11 authors, Bjørn Naume.
Breast Cancer Res, 2017 Nov 16; 19(1). PMID: 29137653    Free PMC article.
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.
Genefu: an R/Bioconductor package for computation of gene expression-based signatures in breast cancer.
Deena M A Gendoo, Natchar Ratanasirigulchai, +4 authors, Benjamin Haibe-Kains.
Bioinformatics, 2015 Nov 27; 32(7). PMID: 26607490    Free PMC article.
Highly Cited.
Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011.
A Goldhirsch, W C Wood, +4 authors, Panel members.
Ann Oncol, 2011 Jun 29; 22(8). PMID: 21709140    Free PMC article.
Highly Cited.
Tumor gene expression and prognosis in breast cancer patients with 10 or more positive lymph nodes.
Melody A Cobleigh, Bita Tabesh, +7 authors, Steven Shak.
Clin Cancer Res, 2005 Dec 20; 11(24 Pt 1). PMID: 16361546
Supervised risk predictor of breast cancer based on intrinsic subtypes.
Joel S Parker, Michael Mullins, +17 authors, Philip S Bernard.
J Clin Oncol, 2009 Feb 11; 27(8). PMID: 19204204    Free PMC article.
Highly Cited.
American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer.
Antonio C Wolff, M Elizabeth H Hammond, +21 authors, American Society of Clinical Oncology/College of American Pathologists.
Arch Pathol Lab Med, 2007 Jan 01; 131(1). PMID: 19548375
Highly Cited.
Molecular Heterogeneity and Response to Neoadjuvant Human Epidermal Growth Factor Receptor 2 Targeting in CALGB 40601, a Randomized Phase III Trial of Paclitaxel Plus Trastuzumab With or Without Lapatinib.
Lisa A Carey, Donald A Berry, +15 authors, Clifford A Hudis.
J Clin Oncol, 2015 Nov 04; 34(6). PMID: 26527775    Free PMC article.
Highly Cited.
Appearance of estrogen positive bilateral breast carcinoma with HER2 gene amplification in a patient with aplastic anemia.
Milica Colović, Milena Todorović, +3 authors, Vladimir Jurišić.
Pol J Pathol, 2014 Aug 15; 65(1). PMID: 25119012
Modeling risk stratification in human cancer.
Thierry Rème, Dirk Hose, Charles Theillet, Bernard Klein.
Bioinformatics, 2013 Mar 16; 29(9). PMID: 23493321
Intrinsic subtypes from the PAM50 gene expression assay in a population-based breast cancer survivor cohort: prognostication of short- and long-term outcomes.
Bette J Caan, Carol Sweeney, +8 authors, Philip S Bernard.
Cancer Epidemiol Biomarkers Prev, 2014 Feb 14; 23(5). PMID: 24521998    Free PMC article.
Bidirectional cross talk between ERalpha and EGFR signalling pathways regulates tamoxifen-resistant growth.
D J Britton, I R Hutcheson, +5 authors, R I Nicholson.
Breast Cancer Res Treat, 2005 Nov 02; 96(2). PMID: 16261397
Discordance of the PAM50 Intrinsic Subtypes Compared with Immunohistochemistry-Based Surrogate in Breast Cancer Patients: Potential Implication of Genomic Alterations of Discordance.
Hee Kyung Kim, Kyung Hee Park, +10 authors, Yeon Hee Park.
Cancer Res Treat, 2018 Sep 08; 51(2). PMID: 30189722    Free PMC article.
Intrinsic subtypes from PAM50 gene expression assay in a population-based breast cancer cohort: differences by age, race, and tumor characteristics.
Carol Sweeney, Philip S Bernard, +11 authors, Bette J Caan.
Cancer Epidemiol Biomarkers Prev, 2014 Feb 14; 23(5). PMID: 24521995    Free PMC article.
PAM50 Risk of Recurrence Score Predicts 10-Year Distant Recurrence in a Comprehensive Danish Cohort of Postmenopausal Women Allocated to 5 Years of Endocrine Therapy for Hormone Receptor-Positive Early Breast Cancer.
Anne-Vibeke Lænkholm, Maj-Britt Jensen, +12 authors, Bent Ejlertsen.
J Clin Oncol, 2018 Jan 26; 36(8). PMID: 29369732
Clinical-Genomic Models of Node-Positive Breast Cancer: Training, Testing, and Validation.
Tzu-Ting Huang, Andre Ching-Hsuan Chen, +2 authors, Skye Hung-Chun Cheng.
Int J Radiat Oncol Biol Phys, 2019 Jul 12; 105(3). PMID: 31295565
The beneficial role of Asian-based RecurIndex test in the prognostic prediction in Chinese male breast cancer patients.
Shuo Zhang, Beichen Liu, +12 authors, Yunjiang Liu.
Sci Rep, 2021 Apr 09; 11(1). PMID: 33828195    Free PMC article.