早期乳腺癌 Oncotype Dx 复发评分与 PREDICT 估计值之间的相关性:单个机构的经验。

IF 3.2 Q2 ONCOLOGY JCO Global Oncology Pub Date : 2024-08-01 DOI:10.1200/GO.24.00112
Ezzeldin M Ibrahim, Bushra A Al-Quzi, Ahmed Y Shaheen, Mohammed H Kulak, Ahmed A Refae, Meteb E Al-Foheidi
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引用次数: 0

摘要

目的:对于激素受体阳性(HR+)、人表皮生长因子受体 2 阴性(HER2-)的结节阴性和结节阳性早期乳腺癌患者,Oncotype Dx 复发评分(RS)具有预后和预测化疗获益的作用。然而,其直接成本可能具有抑制作用。本研究评估了RS和免费在线PREDICT工具对辅助化疗获益估计之间的相关性:对112名肿瘤患者的电子病历进行了回顾性审查,并使用RS和PREDICT工具来估算生存获益。使用斯皮尔曼秩检验和麦克尼玛检验分析了RS和PREDICT估计值之间的相关性:患者的中位年龄为 53 岁(95% CI,50 至 55 岁),大多数患者的腋窝淋巴结为阴性(78%)。虽然RS的绝对值与PREDICT估计的辅助化疗获益呈显著正相关,但在化疗获益的百分比方面,两种方法之间没有发现显著的相关性。值得注意的是,在整个研究人群和亚组中,基于 RS 的风险分配与基于 PREDICT 估值的风险分配之间的不一致率介于 48% 与 67% 之间。在中位随访23.5(95% CI,19.8-27.2)个月期间,仅记录到1例疾病复发和1例乳腺癌相关死亡:我们的研究结果凸显了RS和PREDICT工具在预测HR+、HER2-早期乳腺癌患者辅助化疗获益方面存在明显的不一致。虽然这两种工具都旨在实现癌症治疗的个性化,但它们的不一致性各不相同,这表明无论患者的风险分级如何,PREDICT 都不能取代 RS 来预测辅助化疗的疗效。要探索这些关系并优化乳腺癌治疗中的精准医疗方法,还需要进一步的研究。
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Correlation Between Oncotype Dx Recurrence Score and PREDICT Estimates in Early Breast Cancer: A Single Institution Experience.

Purpose: Oncotype Dx Recurrence Score (RS) is prognostic and predictive of chemotherapy benefit in women with node-negative and node-positive in hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer. Nevertheless, its direct cost may be inhibitive. This study assesses the correlation between the RS and the free online PREDICT tools' estimations of adjuvant chemotherapy benefit.

Patients and methods: A retrospective review of the electronic medical records of 112 patients with tumors tested for the RS and the PREDICT tool was used to estimate survival benefits. The correlation between RS and PREDICT estimations was analyzed using Spearman rank and McNemar tests.

Results: The median age of patients was 53 (95% CI, 50 to 55) years, with most patients having negative axillary lymph nodes (78%). While the absolute value for RS showed significant positive correlations with adjuvant chemotherapy's benefit as estimated by PREDICT, no significant correlations were found between the two methods in the percentage of chemotherapy gain. Notably, discordance rates between 48% and 67% between RS-based risk assignments and those based on PREDICT estimates were significant across the study population and subgroups. Only one disease recurrence and one breast cancer-related death were documented over a median follow-up of 23.5 (95% CI, 19.8 to 27.2) months.

Conclusion: Our findings highlight a significant discordance between RS and PREDICT tools in predicting the benefits of adjuvant chemotherapy in patients with HR+, HER2- early breast cancer. While both tools aim to personalize cancer treatment, their discordance varies, suggesting that PREDICT could not substitute RS to predict adjuvant chemotherapy benefits regardless of patient risk classification. Further studies are needed to explore these relationships and optimize precision medicine approaches in breast cancer management.

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来源期刊
JCO Global Oncology
JCO Global Oncology Medicine-Oncology
CiteScore
6.70
自引率
6.70%
发文量
310
审稿时长
7 weeks
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