Abstract 5865
Background
The 21-gene Breast Recurrence Score® (RS) is an established genomic tool to assess recurrence risk and adjuvant chemotherapy benefit in early breast cancer. The TAILORx study redefined group boundaries of the RS in node negative women. In the 668 patients of the NSABP-B14 study that formed the validation set of the RS younger age was significantly correlated with distant recurrence and tumour size trended toward significance. High tumour grade remained an independent prognostic factor beyond the RS. In the TAILORx study these higher risk groups were under-represented.
Methods
We compared clinical prognostic parameters of women in South East London with available RS with the TAILORx trial population. Retrospective case note analysis of all identified patients between 2013 and 2018 was completed. Women with nodal involvement were excluded. Descriptive statistics were used for comparison with patient characteristics of the TAILORx study.
Results
A total of 269 tests were identified. 42 were excluded for nodal involvement or incomplete clinical data, leaving 227 patients. Differences between the populations are demonstrated for all characteristics and will be presented at the meeting.Table:
263P Patient characteristic
RS | <11 | 11-25 | >26 | ALL |
N (%) | 34 (11) | 142 (67) | 51 (22) | 227 (100) |
Median age (range) | 48 (28-75) | 49 (28-74) | 53 (38-78) | 50 (28-78) |
≤50 yr % | 56 | 56 | 41 | 52 |
Premenopausal % | 59 | 64 | 47 | 59 |
Tumour size in cm Median (IQR) Mean (SD) | 2.0 (1.7-3.0) 2.6 ± 1.5 | 2.1 (1.5-3.0) 2.6 ± 1.8 | 2.2 (1.6-3.0) 2.4 ± 1.2 | 2.1 (1.6-3.0) 2.6 ± 1.6 |
Tumour grade % Low Intermediate High | 6 74 21 | 4 63 33 | 0 24 76 | 4 56 41 |
Clinical risk % Low High High (TAILORx) | 35 65 22 | 32 68 26 | 20 80 57 | 30 70 |
Conclusions
Our patients have a higher clinical risk than the TAILORx population. They are younger and have larger, higher grade cancers. This population is under-represented in the TAILORx study which was unable to exclude benefit in the ≤ 50 subset and may thus underestimate benefit from chemotherapy in our population. The current RS reporting is biased towards an older, low-risk population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
C. Gousis: Travel / Accommodation / Expenses: Roche. H. Kristeleit: Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Novartis; Advisory / Consultancy, Speaker Bureau / Expert testimony: Eisai; Advisory / Consultancy: Roche. All other authors have declared no conflicts of interest.
Resources from the same session
4250 - Phase II study of avelumab in combination with cetuximab as a rechallenge strategy in pre-treated RAS wild type metastatic colorectal cancer patients: CAVE (cetuximab-avelumab) Colon.
Presenter: Erika Martinelli
Session: Poster Display session 2
Resources:
Abstract
5234 - The ORCHESTRA trial; A phase III trial of adding tumor debulking to systemic therapy versus systemic therapy alone in multi-organ metastatic colorectal cancer (mCRC).
Presenter: Lotte Bakkerus
Session: Poster Display session 2
Resources:
Abstract
5294 - EMERGE: Epigenetic Modulation of the Immune Response in Gastrointestinal cancers
Presenter: Elizabeth Cartwright
Session: Poster Display session 2
Resources:
Abstract
913 - Phase III, international, multicenter, randomized, open-label trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P/G) vs gemcitabine (G) alone for surgically resected pancreatic adenocarcinoma (APACT): subgroup analyses
Presenter: Margaret Tempero
Session: Poster Display session 2
Resources:
Abstract
1668 - FOLFIRINOX in locally advanced (LA) and borderline resectable (BR) pancreatic adenocarcinoma : update of the AGEO cohort.
Presenter: Edouard Auclin
Session: Poster Display session 2
Resources:
Abstract
2559 - Impact of adjuvant treatment with nab-paclitaxel and gemcitabine (nab-P+GEM) vs gemcitabine alone (GEM) on health-related quality of life (QoL) in patients (pts) with surgically resected pancreatic adenocarcinoma (PA) in the Adjuvant Pancreatic Adenocarcinoma Clinical Trial (APACT)
Presenter: Hanno Riess
Session: Poster Display session 2
Resources:
Abstract
4897 - Early detection of pancreatic ductal adenocarcinoma using methylation signatures in circulating tumor DNA
Presenter: Xiao-ding Liu
Session: Poster Display session 2
Resources:
Abstract
1755 - Evaluation of minimal important difference (MID) for the European Organisation for Research and Treatment of Cancer (EORTC) Pancreatic Cancer Module (PAN26) in patients with surgically resected pancreatic adenocarcinoma
Presenter: Michele Reni
Session: Poster Display session 2
Resources:
Abstract
2876 - Multispectral analysis of lymphocyte complexity in periampullary adenocarcinoma
Presenter: Sebastian Lundgren
Session: Poster Display session 2
Resources:
Abstract
1902 - Phase II trial of preoperative modified FOLFIRINOX (mFOLFIRINOX) followed by postoperative gemcitabine (GEM) in patients (pts) with borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC)
Presenter: Jae Ho Jeong
Session: Poster Display session 2
Resources:
Abstract