191P - Pathological Proliferation Score to predict genomic risk categories in Early Stage Breast Cancer

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Breast Cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Ajaz Bulbul
Citation Annals of Oncology (2017) 28 (suppl_5): v43-v67. 10.1093/annonc/mdx362
Authors A. Bulbul1, D. Tsao-Wei2, E.A. Mino1, A. Mustafa3, S. Rashad4, H. Abboud5, S. Chouial1, T. Braik1, K. Masoud1, D. Tripathy6
  • 1Hematology/ Oncology, Kymera Independent Physicians, 88220 - Carlsbad/US
  • 2Biostatistics, University of Southern California Norris Comprehensive Cancer Center, 90033 - Los Angeles/US
  • 3Anesthesiology, Acharya Shri Chander College of Medical Sciences and Hospital, 180017 - Jammu/IN
  • 4Medicine, All Saints University of Medicine, 00109 - Roseau/DM
  • 5Medicine, Windsor University, 60449 - Monee/US
  • 6Medical Oncology, MD Anderson Cancer Center, 77030-4095 - Houston/US



Five of the 16 cancer-related genes used to calculate the Recurrence score (RS) are proliferative genes. Appropriate utilization of an expensive test is important especially in areas of limited resources. A relatively inexpensive ‘Pathological Proliferative score’ (PrS) of a tumor may help group patients in risk categories correlating with the RS.


We retrospectively studied 205 patients with Lymph node negative, hormone receptor (HR) positive, HER2 negative status (ODX candidates) between1990-2015 treated across three rural community oncology practices. Proliferation score was calculated by combining tumor grade, visual mitotic score and Ki67 immunostaining (on a scale of 1-3, lowest score of 3; highest score of 9). Log-rank test was used for survival analysis.


PrS correlated with ODX risk recurrence (p 


PrS which may represent an inexpensive screening approach to identify patients with a low ODX RS that have excellent outcomes despite the type of adjuvant treatment. ODX testing is unlikely to re-categorize them. Higher (5-9) PrS was not predictive of chemotherapy benefit, unlike high ODX. Lack of standardization of Ki67 staining, retrospective nature of the study while important should be tested in an expanded and prospective setting.

Clinical trial identification

Legal entity responsible for the study

Kymera Independent Physicians




All authors have declared no conflicts of interest.