Abstract 102P
Background
The HER2DX risk-score has been validated across several studies in patients (pts) with early-stage HER2+ breast cancer, including the 1st release of the SCAN-B cohort (n=378; EBioMedicine 2022). Here, we report the result of the HER2DX risk-score in the latest release of the SCAN-B HER2+ cohort, which includes a larger sample size, longer follow-up and treatment information.
Methods
The clinical and RNAseq data from the SCAN-B dataset was obtained from GEO (GSE81538). Among 6600 pts, 819 had HER2+ breast cancer and 757 pts had research-based HER2DX risk-score and survival outcomes. The HER2DX risk-score was evaluated i) as a continuous variable and ii) using predefined cut-offs. The primary endpoint for this study was overall survival (OS). The Kaplan-Meier method and Cox models were used to estimate survival outcomes.
Results
Median follow-up was 7.5 years (n=757). Most pts received chemotherapy (85.1%) and trastuzumab (79.1%), most tumours were T1-T2 (97.1%) and hormone receptor-positive (71.5%). HER2DX risk-score was associated with OS as a continuous variable (OS HR per 10-units increment=1.39, 95%CI 1.27-1.5; p<0.001) and using the predefined risk groups (cut-off=50; OS HR=2.91, 1.95-4.34; p<0.001). HER2DX risk-score remained associated with OS after adjustment by clinical variables and treatment regimen (multivariable analysis, Table). Among HER2+ T1N0 tumours (n=297), HER2DX high-risk had an inferior OS than low-risk (cut-off=50 [5.0% high-risk]; 7-years OS 68.9% vs 93.0%, p=0.02)) and using cut-off=32 ([24.6% high-risk]; 7-years OS 80.0% vs 94.9%, p=0.002). Similar results were obtained in other survival endpoints.
Table: 102P
HR (95% CI) | p-value | ||
HER2DX risk-score (10-units increment) | 1.41 (1.17 - 1.69) | <0.001 | |
Age (10-year increment) | 1.46 (1.24 - 1.72) | <0.001 | |
Clinical tumor stage | T1 | Ref | - |
T2 | 0.73 (0.42 - 1.28) | 0.28 | |
T3-T4 | 0.98 (0.17 - 5.51) | 0.98 | |
Clinical nodal stage | N0 | Ref | - |
N1 | 0.42 (0.22 - 0.81) | 0.01 | |
N2 | 0.63 (0.27 - 1.47) | 0.28 | |
Estrogen receptor | Negative | Ref | |
Positive | 0.16 (0.05 - 0.47) | <0.001 | |
Nottingham histological grade | 1-2 | Ref | - |
3 | 1.21 (0.79 - 1.87) | 0.38 | |
Hormone receptor | Negative | Ref | - |
Positive | 9.66 (3.23 - 28.9) | <0.001 | |
Size (1-mm increment) | 1.02 (0.99 - 1.04) | 0.09 | |
Treatment | None | Ref | - |
CT/Endocrine trt (or both) | 0.83 (0.42 - 1.65) | 0.59 | |
Trastuzumab + CT | 0.45 (0.23 - 0.89) | 0.02 | |
Trastuzumab + CT+ Endocrine trt | 0.20 (0.09 - 0.42) | <0.001 |
Conclusions
In patients with early-stage HER2+ breast cancer, HER2DX risk-score provides prognostic information beyond clinical-pathological variables, including treatment regimen with or without trastuzumab.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
T. Pascual: Financial Interests, Personal, Invited Speaker: Pfizer/ AstraZeneca / Veracyte / Novartis; Financial Interests, Personal, Advisory Board: Roche/Genentech. G. Villacampa: Financial Interests, Personal, Invited Speaker, Invited speaker in a course: MSD; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Invited Speaker, Invited speaker in an internal training: Pierre Fabrer, GSK; Financial Interests, Personal, Invited Speaker, Internal discussion about the interpretation of some published results: Pfizer; Financial Interests, Personal, Other, Collaborations with specific projects: Reveal Genomics. F. Brasó-Maristany: Financial Interests, Personal, Invited Speaker: Reveal Genomics. L. Pare Brunet: Financial Interests, Institutional, Full or part-time Employment: Reveal Genomics S.L.; Financial Interests, Institutional, Other, Patent pending: In vitro method for the prognosis of patients suffering from HER2-positive breast cancer - 905333: Reveal Genomics S.L. O. Martinez Saez: Financial Interests, Personal, Invited Speaker: Novartis, Eisai; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Other, Travel expenses: Roche; Financial Interests, Personal, Other, Medical advisory: Reveal Genomics. J. Cortés: Financial Interests, Personal, Advisory Board: Roche, Celgene, Cellestia, AstraZeneca, Seattle Genetics, Daiichi Sankyo, Erytech, Athenex, Polyphor, Lilly, MERCK SHARP& DOHME, GSK, LEUKO, Bioasis, Clovis oncology, Boehringer Ingelheim, Ellipses, Hibercell, BioInvent, Gemoab, Gilead, Menarini, Zymeworks, Reveal Genomics; Financial Interests, Personal, Invited Speaker: Roche, Novartis, Celgene, Eisai, Pfizer, Samsung Bioepis, Lilly, MERCK SHARP& DOHME, Daiichi Sankyo; Financial Interests, Personal, Other, Consulting/advisor: Expres2ion Biotechnologies; Financial Interests, Personal, Stocks/Shares: MedSIR, Nektar Therapeutics; Financial Interests, Institutional, Research Grant: Roche, Ariad Pharmaceuticals, AstraZeneca, Baxalta GMBH/Servier Affaires, Bayer healthcare, Eisai, Guardanth health, Merck Sharp&Dohme, Pfizer, Piqur Therapeutics, Puma B, Queen Mary University of London; Other, Travel cost and expenses: Roche, Novartis, Eisai, Daiichi Sankyo, Pfizer, Gilead, AstraZeneca. 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