Breast cancer prognostic tests have shown significant variation in their abilities to predict disease recurrence, according to a study published in JAMA Oncology (online February 15, 2018; doi:10.1001/jamaoncol.2017.5524).
There are multiple molecular signatures available for managing estrogen receptor (ER)-positive breast cancer. However, limited data exist that directly compare these prognostic tests to help guide treatment decisions.
Ivana Sestak, PhD, Queen Mary University of London (England), and colleagues conducted a retrospective biomarker analysis included 774 postmenopausal women with ER-positive, ERBB2-negative disease. Data was collected as a preplanned secondary study from the Anastrozole or Tamoxifen Alone or Combined randomized clinical trial from January 2009 through April 2015. The signatures included the Oncotype Dx recurrence score, PAM50-based Prosigna risk of recurrence (ROR), Breast Cancer Index (BCI), EndoPredict (EPclin), Clinical Treatment Score, and 4-marker immunohistochemical score.
Researchers compared the prognostic value of these signatures in addition to the Clinical Treatment score—measured by nodal status, tumor size, grade, age, and endocrine treatment—for distant recurrence 0 to 10 years and 5 to 10 years after diagnosis.
For women with node-negative disease, the signatures providing the most prognostic information were ROR, followed by BCI and EPclin. Each test provided significantly more information than the clinical treatment score, the recurrence score, and the 4-marker immunohistochemical score. Significantly less information was provided by all six molecular tests for the patients with one to three positive nodes, but the BCI and EPclin provided more additional prognostic information than the other signatures.
