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A Biological Signat...
A Biological Signature for Breast Ductal Carcinoma In Situ to Predict Radiotherapy Benefit and Assess Recurrence Risk
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- Bremer, Troy (author)
- PreludeDx, 26051 Merit Circle Suite 102, Laguna Hills, CA 92653 USA
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- Whitworth, Pat W (author)
- Nashville Breast Center,Nashville Breast Ctr, Nashville, TN USA
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- Patel, Rakesh (author)
- PIH Health Good Samaritan Hospital,Good Samaritan Canc Ctr, Los Gatos, CA USA
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- Savala, Jess (author)
- PreludeDx, 26051 Merit Circle Suite 102, Laguna Hills, CA 92653 USA
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- Barry, Todd (author)
- Spectrum Pathology Inc.,Spectrum Pathol Inc, Mission Viejo, CA USA
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- Lyle, Stephen (author)
- University of Massachusetts,Univ Massachusetts, Sch Med, Worcester, MA USA
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- Leesman, Glen (author)
- PreludeDx, 26051 Merit Circle Suite 102, Laguna Hills, CA 92653 USA
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- Linke, Steven P (author)
- Steven P Linke Consulting, Carlsbad, CA USA
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- Jirström, Karin (author)
- Lund University,Lunds universitet,Terapeutisk patologi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Therapeutic pathology,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Univ, Div Oncol & Pathol, Dept Clin Sci, Lund, Sweden
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- Zhou, Wenjing (author)
- Uppsala universitet,Uppsala University,Endokrinkirurgi
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- Amini, Rose-Marie (author)
- Uppsala universitet,Uppsala University,Klinisk och experimentell patologi,Rose-Marie Amini
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- Wärnberg, Fredrik (author)
- Uppsala universitet,Uppsala University,Endokrinkirurgi
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(creator_code:org_t)
- 2018
- 2018
- English.
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In: Clinical cancer research : an official journal of the American Association for Cancer Research. - 1078-0432 .- 1557-3265. ; 24:23, s. 5895-5901
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Abstract
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- PURPOSE: Ductal carcinoma in situ (DCIS) patients and their physicians currently face challenging treatment decisions with limited information about the individual's subsequent breast cancer risk or treatment benefit. The DCISionRT biological signature developed in this study provides recurrence risk and predicts radiotherapy (RT) benefit for DCIS patients following breast-conserving surgery (BCS).EXPERIMENTAL DESIGN: A biological signature that calculates an individualized Decision Score (DS) was developed and cross-validated in 526 DCIS patients treated with BCS ± RT. The relationship was assessed between DS and 10-year risk of invasive breast cancer (IBC) or any ipsilateral breast event (IBE), including IBC or DCIS. RT benefit was evaluated by risk group and as a function of DS.RESULTS: The DS was significantly associated with IBC and IBE risk, HR (per 5 units) of 4.2 and 3.1, respectively. For patients treated without RT, DS identified a Low Group with 10-year IBC risk of 4% (7% IBE) and an Elevated Risk Group with IBC risk of 15% (23% IBE). In analysis of DS and RT by group, the Elevated Risk Group received significant RT benefit, HR of 0.3 for IBC and IBE. In a clinicopathologically low-risk subset, DS reclassified 42% of patients into the Elevated Risk Group. In an interaction analysis of DS and RT, patients with elevated DS had significant RT benefit over baseline.CONCLUSIONS: The DS was prognostic for risk and predicted RT benefit for DCIS patients. DS identified a clinically meaningful low-risk group and a group with elevated 10-year risks that received substantial RT benefit over baseline.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Klinisk laboratoriemedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Clinical Laboratory Medicine (hsv//eng)
Keyword
- Adult
- Aged
- Biomarkers, Tumor
- Breast Neoplasms/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Combined Modality Therapy
- Female
- Humans
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local
- Prognosis
- Proportional Hazards Models
- Treatment Outcome
- Tumor Burden
- Patologi
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Bremer, Troy
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Whitworth, Pat W
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Patel, Rakesh
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Savala, Jess
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Barry, Todd
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Lyle, Stephen
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show more...
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Leesman, Glen
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Linke, Steven P
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Jirström, Karin
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Zhou, Wenjing
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Amini, Rose-Mari ...
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Wärnberg, Fredri ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Clinical Laborat ...
- Articles in the publication
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Clinical cancer ...
- By the university
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Lund University
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Uppsala University