TY - JOUR
T1 - Prognostic Utility of Breast Cancer Index to Stratify Distant Recurrence Risk in Invasive Lobular Carcinoma
AU - Nunes, Raquel
AU - Sella, Tal
AU - Treuner, Kai
AU - Atkinson, Jennifer M.
AU - Wong, Jenna
AU - Zhang, Yi
AU - Exman, Pedro
AU - Dabbs, David
AU - Richardson, Andrea L.
AU - Schnabel, Catherine A.
AU - Sgroi, Dennis C.
AU - Oesterreich, Steffi
AU - Cimino-Mathews, Ashley
AU - Metzger, Otto
N1 - Funding Information:
Funding was provided by Biotheranostics, Inc., and in part by the Breast Cancer Research Foundation (to A.L. Richardson, D.C. Sgroi, and S. Oesterreich). T. Sella is supported by The American Physicians Fellowship for Medicine in Israel and the Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel. A.L. Richardson receives support from the Judy and Peter Blum Kovler Foundation. Special thanks to Ranelle Salunga, Tristan Harris, Jose Ramirez, Yen Tran, Veena Singh, MD, and Peter Gray, PhD, for their support of the trial and excellent technical expertise. This project used the UPMC Hillman Cancer Center and Tissue and Research Pathology/Pitt Biospecimen Core shared resource which is supported in part by award P30CA047904, as well as resources from the DF/ HCC Breast SPORE: Specialized Program of Research Excellence (SPORE), an NCI-funded program, Grant 1P50CA168504. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health/NCI.
Funding Information:
Funding was provided by Biotheranostics, Inc., and in part by the Breast Cancer Research Foundation (to A.L. Richardson, D.C. Sgroi, and S. Oesterreich). T. Sella is supported by The American Physicians Fellowship for Medicine in Israel and the Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel. A.L. Richardson receives support from the Judy and Peter Blum Kovler Foundation. Special thanks to Ranelle Salunga, Tristan Harris, Jose
Publisher Copyright:
©2021 The Authors; Published by the American Association for Cancer Research
PY - 2021/10/15
Y1 - 2021/10/15
N2 - Purpose: The prognostic utility of Breast Cancer Index (BCI) for risk assessment of overall (0–10 years), early (0–5 years), and late (5–10 years) distant recurrence (DR) in hormone receptor–positive (HRþ) invasive lobular carcinoma (ILC) was evaluated. Experimental Design: BCI gene expression analysis was performed blinded to clinical outcome utilizing tumor specimens from patients with HRþ ILC from a multi-institutional cohort. The primary endpoint was time to DR. Kaplan–Meier analyses of overall, early, and late DR risk were performed, and statistical significance was evaluated by log-rank test and Cox proportional hazards regression. The prognostic contribution of BCI in addition to clinicopathologic factors was evaluated by likelihood ratio analysis. Results: Analysis of 307 patients (99% ERþ, 53% T1, 42% Nþ, 70% grade II) showed significant differences in DR over 10 years based on BCI risk categories. BCI low- and intermediate-risk patients demonstrated similar DR rates of 7.6% and 8.0%, respectively, compared with 27.0% for BCI high-risk patients. BCI was a significant independent prognostic factor for overall 10-year DR [HR ¼ 4.09; 95% confidence interval (CI), 2.00–8.34; P ¼ 0.0001] as well as for both early (HR ¼ 8.19; 95% CI, 1.85–36.30; P ¼ 0.0042) and late (HR ¼ 3.04; 95% CI, 1.32–7.00; P ¼ 0.0224) DR. In multivariate analysis, BCI remained the only statistically significant prognostic factor for DR (HR ¼ 3.49; 95% CI, 1.28–9.54; P ¼ 0.0150). Conclusions: BCI is an independent prognostic factor for ILC and significantly stratified patients for cumulative risk of 10-year, early, and late DR. BCI added prognostic value beyond clinicopathologic characteristics in this distinct subtype of breast cancer.
AB - Purpose: The prognostic utility of Breast Cancer Index (BCI) for risk assessment of overall (0–10 years), early (0–5 years), and late (5–10 years) distant recurrence (DR) in hormone receptor–positive (HRþ) invasive lobular carcinoma (ILC) was evaluated. Experimental Design: BCI gene expression analysis was performed blinded to clinical outcome utilizing tumor specimens from patients with HRþ ILC from a multi-institutional cohort. The primary endpoint was time to DR. Kaplan–Meier analyses of overall, early, and late DR risk were performed, and statistical significance was evaluated by log-rank test and Cox proportional hazards regression. The prognostic contribution of BCI in addition to clinicopathologic factors was evaluated by likelihood ratio analysis. Results: Analysis of 307 patients (99% ERþ, 53% T1, 42% Nþ, 70% grade II) showed significant differences in DR over 10 years based on BCI risk categories. BCI low- and intermediate-risk patients demonstrated similar DR rates of 7.6% and 8.0%, respectively, compared with 27.0% for BCI high-risk patients. BCI was a significant independent prognostic factor for overall 10-year DR [HR ¼ 4.09; 95% confidence interval (CI), 2.00–8.34; P ¼ 0.0001] as well as for both early (HR ¼ 8.19; 95% CI, 1.85–36.30; P ¼ 0.0042) and late (HR ¼ 3.04; 95% CI, 1.32–7.00; P ¼ 0.0224) DR. In multivariate analysis, BCI remained the only statistically significant prognostic factor for DR (HR ¼ 3.49; 95% CI, 1.28–9.54; P ¼ 0.0150). Conclusions: BCI is an independent prognostic factor for ILC and significantly stratified patients for cumulative risk of 10-year, early, and late DR. BCI added prognostic value beyond clinicopathologic characteristics in this distinct subtype of breast cancer.
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U2 - 10.1158/1078-0432.CCR-21-0733
DO - 10.1158/1078-0432.CCR-21-0733
M3 - Article
C2 - 34376532
AN - SCOPUS:85117463109
SN - 1078-0432
VL - 27
SP - 5688
EP - 5696
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 20
ER -