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The predictive value of NHS PREDICT for triple negative breast cancer

Date

03 May 2019

Session

Poster lunch

Presenters

Monika Sobocan

Citation

Annals of Oncology (2019) 30 (suppl_3): iii65-iii71. 10.1093/annonc/mdz101

Authors

M. Sobocan1, U. Belak2, N. Sikošek Čas1, N. Kozar2, K.K. Krajnc1, I. Takac1, D. Arko1

Author affiliations

  • 1 Clinic Of Gynecology And Perinatology, University Medical Center Maribor, 2000 - Maribor/SI
  • 2 Clinic Of Gynecology And Perinatology, University Medical Center Maribor, Maribor/SI
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Background

Tools to support clinical decision making regarding breast cancer (BC) are becoming more available to clinicians. NHS PREDICT is a freely available web-based tool for prognostication and assistance in BC management. Recent research shows doubt in using the tool for BC subtypes. There is fear over the possibility of over- or undertreatment of patients.

Methods

Ninety-four patients regardless of their ER (estrogen receptor), PR (progesterone receptor) and HER2 (human epidermal growth factor receptor 2) status were included in this study. Through using the platform NHS PREDICT 2.0 we evaluated through the pilot study the prediction of patients with newly diagnosed breast cancer. We evaluated the prediction of 10-year survival, benefit of surgical treatment, treatment with hormonal therapy, transtuzumab treatment and benefit of chemotherapy.

Results

The median age at diagnosis was 60.10 years (SD 14.4). Patients were classified according to hormonal status: i) ER+ BC (n = 69), ii) ER+ and HER2+ BC (n = 8), iii) ER-, but HER2+ BC (n = 7) and iv) triple negative BC (n = 10). Overall 10-year survival for ER+, HER2- was 86.1 % (benefit of adjuvant chemotherapy adding 2.8 %), for ER- and HER2+ 83.7% (benefit of adjuvant chemotherapy adding 7.0 %) and for TNBC 77.4% (benefit of adjuvant chemotherapy 5.5 %). Overall data is represented in Table.

Conclusions

This pilot analysis estimates that overall survival was in accordance to available treatment data. TNBC 10-year survival was appropriate (decreased), but the tool estimated very low chemotherapy benefits for TNBC patients in comparison to other patient groups thus posing the risk of patient undertreatment.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The University Medical Center Maribor.

Funding

Supported through the Slovenian Research Agency Project (J3-9272).

Disclosure

All authors have declared no conflicts of interest.

Table: 216P

Predict output on breast cancer subtypes

Breast cancer subtypes10-year age adjusted overall survivalMean age at time of diagnosisBenefit of surgical treatment on survivalBenefit of hormonal therapy on survivalBenefit of chemotherapy on survivalBenefit of transtuzumab on survival
ER+, PR+, Her2- (n = 69)86.1 (SD 15.1)58.7 (SD 13.2)73.32 (SD 16.3)3.71 (SD 2.8)2.8 (SD 2.1)/
ER+, PR+, Her2 + (n = 8)88.9 (SD 11.0)57.6 (SD 12.1)64.9 (SD 20.9)6.5 (SD 3.7)4.7 (SD 2.8)3.6 (SD 2.1)
ER-, PR-, Her2 + (n = 7)83.7 (SD 18.4)56.3 (SD 19.9)50.9 (SD 23.5)/7.0 (SD 1.7)7.0 (SD 2.0)
ER-, PR-, Her2- (n = 10)77.4 (SD 21.8)62.5 (SD 17.7)52.9 (SD 23.2)/5.5 (SD 2.4)/

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