Omission of Chemotherapy in HR+/HER2− Early Invasive Breast Cancer Based on Combined 6-IHC Score? (original) (raw)
2021, Clinical Breast Cancer
1. This study involves the clinical determination of whether HR + /HER2 − early BC needs chemotherapy and seeks for a more accurate and cheaper method. 2. Select genes related to BC invasion and metastasis, and establish a scoring model for their immunohistochemical results by Cox regression. 3. The scoring model can well judge the prognosis of HR + /HER2 − BC patients. Purpose: Current methods of judging whether HR + /HER2 − breast cancer (BC) require adjuvant therapy, such as Ki67 and multigene prognostic tests, cannot balance accuracy with the price most patients can afford. Methods: A retrospective analysis of 330 HR + /HER2 − BC patients was conducted. Six BC-related genes (Cathepsin L2, MMP11, CyclinB1, Aurora A, Survivin, and Ki67) were screened using univariate and multivariate COX regression, and correlate clinical follow-up with immunohistochemical expression (designated as 6-IHC). All the included patients were divided randomly at a 7:3 ratio into training and testing cohorts. The cutoff prognosis index (PI) of 6-IHC was determined by multivar iate Cox r isk regression analysis after calculating the PI of each patient in training cohort and confirmed in testing cohort. Kaplan-Meier (KM) method was used to analyze Disease-free survival (DFS) and overall survival (OS). Six-IHC score and other factors associated with survival benefit of adjuvant chemotherapy were compared with Ki67 index. Results: The receiver operating characteristic curve analysis showed that the patients can be divided into 6-IHC score "High" and "Low" risk groups. The 8-year DFS and OS of the KM curves showed that chemotherapy did not significantly improve the DFS in the 6-IHC score "Low" risk group (P = 0.830), but significantly improved the DFS in the 6-IHC score "High" risk group (P = 0.012). Conclusions: Combined 6-IHC score could be a reliable tool in predicting cancer-specific recurrences and survival in HR + /HER2-breast cancer patients, with additional advantages over using immunohistochemical expression of Ki67.
Sign up for access to the world's latest research.
checkGet notified about relevant papers
checkSave papers to use in your research
checkJoin the discussion with peers
checkTrack your impact
Loading Preview
Sorry, preview is currently unavailable. You can download the paper by clicking the button above.