Validation and clinical utility of a 70-gene prognostic signature for women with node-negative breast cancer - PubMed (original) (raw)
Multicenter Study
. 2006 Sep 6;98(17):1183-92.
doi: 10.1093/jnci/djj329.
Sherene Loi, Laura van't Veer, Giuseppe Viale, Mauro Delorenzi, Annuska M Glas, Mahasti Saghatchian d'Assignies, Jonas Bergh, Rosette Lidereau, Paul Ellis, Adrian Harris, Jan Bogaerts, Patrick Therasse, Arno Floore, Mohamed Amakrane, Fanny Piette, Emiel Rutgers, Christos Sotiriou, Fatima Cardoso, Martine J Piccart; TRANSBIG Consortium
Affiliations
- PMID: 16954471
- DOI: 10.1093/jnci/djj329
Multicenter Study
Validation and clinical utility of a 70-gene prognostic signature for women with node-negative breast cancer
Marc Buyse et al. J Natl Cancer Inst. 2006.
Abstract
Background: A 70-gene signature was previously shown to have prognostic value in patients with node-negative breast cancer. Our goal was to validate the signature in an independent group of patients.
Methods: Patients (n = 307, with 137 events after a median follow-up of 13.6 years) from five European centers were divided into high- and low-risk groups based on the gene signature classification and on clinical risk classifications. Patients were assigned to the gene signature low-risk group if their 5-year distant metastasis-free survival probability as estimated by the gene signature was greater than 90%. Patients were assigned to the clinicopathologic low-risk group if their 10-year survival probability, as estimated by Adjuvant! software, was greater than 88% (for estrogen receptor [ER]-positive patients) or 92% (for ER-negative patients). Hazard ratios (HRs) were estimated to compare time to distant metastases, disease-free survival, and overall survival in high- versus low-risk groups.
Results: The 70-gene signature outperformed the clinicopathologic risk assessment in predicting all endpoints. For time to distant metastases, the gene signature yielded HR = 2.32 (95% confidence interval [CI] = 1.35 to 4.00) without adjustment for clinical risk and hazard ratios ranging from 2.13 to 2.15 after adjustment for various estimates of clinical risk; clinicopathologic risk using Adjuvant! software yielded an unadjusted HR = 1.68 (95% CI = 0.92 to 3.07). For overall survival, the gene signature yielded an unadjusted HR = 2.79 (95% CI = 1.60 to 4.87) and adjusted hazard ratios ranging from 2.63 to 2.89; clinicopathologic risk yielded an unadjusted HR = 1.67 (95% CI = 0.93 to 2.98). For patients in the gene signature high-risk group, 10-year overall survival was 0.69 for patients in both the low- and high-clinical risk groups; for patients in the gene signature low-risk group, the 10-year survival rates were 0.88 and 0.89, respectively.
Conclusions: The 70-gene signature adds independent prognostic information to clinicopathologic risk assessment for patients with early breast cancer.
Comment in
- Development and evaluation of therapeutically relevant predictive classifiers using gene expression profiling.
Simon R. Simon R. J Natl Cancer Inst. 2006 Sep 6;98(17):1169-71. doi: 10.1093/jnci/djj364. J Natl Cancer Inst. 2006. PMID: 16954463 No abstract available. - Can a 70-gene signature provide useful prognostic information in patients with node-negative breast cancer?
Modlich O, Bojar H. Modlich O, et al. Nat Clin Pract Oncol. 2007 Apr;4(4):216-7. doi: 10.1038/ncponc0747. Epub 2007 Feb 6. Nat Clin Pract Oncol. 2007. PMID: 17290242 No abstract available.
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