Abstract 1156
Background
Decision on adjuvant chemotherapy for early breast cancer can be guided by genomic assays. PREDICT is a validated free online tool that estimates the benefit from adjuvant chemotherapy using clinical and pathological data. The concordance of expected clinical decisions guided by Oncotype analysis and the PREDICT in unknown.
Methods
A retrospective single center cohort study comprising all women with estrogen receptor (ER) positive, human epidermal growth factor receptor 2 negative, node negative disease, whose tumors were sent for OncotypeDX analysis. Estimation of 10-year overall survival (OS) benefit from 2nd generation chemotherapy was calculated using the PREDICT 2.1v tool. Omission of chemotherapy was expected to be advised when Oncotype recurrence score (RS) was ≤25 or when the estimated 10-year OS benefit by the PREDICT was <2%. The tests were considered concordant for women with RS ≤ 25 and estimated PREDICT benefit<2% or for women with RS > 25 and estimated PREDICT benefit ≥2%. Concordance was presented using percentages and the K coefficient. The impact on concordance of pre-specified histological features was assessed, including tumor size, intensity of ER and progesterone receptor (PR), grade, Ki67 and perineural and lymphovascular invasion. The difference between the subgroups was calculated using Chi-squared test.
Results
A total of 445 women were included. Overall concordance was 75% (K = 0.284), with 55 (12.5%) women with low RS but estimated PREDICT benefit ≥2% and 55 (12.5%) with high RS and estimated PREDICT benefit<2%. The concordance was significantly higher for grade 1 disease compared to grade 2-3 (93% vs 72%, p < 0.001), tumor ≤1cm compared to > 1cm (85% vs 72%, p = 0.009), PR positive compared to PR negative (78% vs 58%, p < 0.001) and ki67<20% compared to ≥ 20% (82% vs 54%, p < 0.001). The intensity of ER and the presence of perineural or lymphovascular invasion had no significant impact on concordance.
Conclusions
Compared to PREDICT, using Oncotype in node negative, ER positive disease is expected to change clinical decision in a quarter of patients. The concordance is influenced by pathological features. The use of Oncotype may not be necessary for clinically very low risk patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
H. Goldvaser: Honoraria (self): Roche. R. Yerushalmi: Honoraria (self): Roche; Honoraria (self): Medison; Honoraria (self): AstraZeneca; Honoraria (self): Novartis; Honoraria (self): Teva. M. Sarfaty: Honoraria (self): Roche; Honoraria (self): MSD; Honoraria (self): Medison; Honoraria (self): Novartis. All other authors have declared no conflicts of interest.
Resources from the same session
714 - The feasibility and efficacy of gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian insufficiency in patient with malignant ovarian germ cell tumors
Presenter: Min Kyu Kim
Session: Poster Display session 2
Resources:
Abstract
1753 - Ex vivo cytotoxicity and in vivo antitumor activity of a novel highly selective STAT3 inhibitor YHO-1701 for ovarian and endometrial cancer
Presenter: Kosei Hasegawa
Session: Poster Display session 2
Resources:
Abstract
3739 - Mutational landscapes and tumor mutational burden expression in endometrial cancer
Presenter: Yingli Zhang
Session: Poster Display session 2
Resources:
Abstract
2109 - Clinical features and frequency of mismatch repair protein deficiency in ovarian clear cell and endometrioid carcinoma patients.
Presenter: Kazuhiro Takehara
Session: Poster Display session 2
Resources:
Abstract
4554 - Prospective study evaluating white adipose tissue inflammation and clinicopathologic features in endometrial cancer
Presenter: Lea Moukarzel
Session: Poster Display session 2
Resources:
Abstract
3645 - Cancer-specific survival with or without adjuvant chemotherapy in high-risk stage I endometrial cancer
Presenter: Jenny Ko
Session: Poster Display session 2
Resources:
Abstract
3394 - Pembrolizumab in Patients with MSI-H Advanced Endometrial Cancer from the KEYNOTE-158 Study
Presenter: David Omalley
Session: Poster Display session 2
Resources:
Abstract
3388 - Who drops out of cervical cancer screening? Results from the EDIFICE 6 survey
Presenter: Thibault de La Motte Rouge
Session: Poster Display session 2
Resources:
Abstract
2485 - Identification of a RNA-Seq Based Signature to Improve Prognostic for Uterine Sarcoma
Presenter: Jian-Guo Zhou
Session: Poster Display session 2
Resources:
Abstract
1049 - The Effect Of Multiple Interventions For Women At Risk For Cervical Cancer On Their Health Responsibility, Beliefs Regarding Cervical Cancer, And Having Screening: A Randomized Controlled Experiment
Presenter: Busra Altinel
Session: Poster Display session 2
Resources:
Abstract