PAM50 gene signatures and breast cancer prognosis with adjuvant anthracycline-and taxane-based chemotherapy: Correlative analysis of C9741 (alliance)

Minetta C Liu, Brandelyn N. Pitcher, Elaine R. Mardis, Sherri R. Davies, Paula N. Friedman, Jacqueline E. Snider, Tammi L. Vickery, Jerry P. Reed, Katherine Deschryver, Baljit Singh, William J. Gradishar, Edith A. Perez, Silvana Martino, Marc L. Citron, Larry Norton, Eric P. Winer, Clifford A. Hudis, Lisa A. Carey, Philip S. Bernard, Torsten O. NielsenCharles M. Perou, Matthew J. Ellis, William T. Barry

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Abstract

PAM50 intrinsic breast cancer subtypes are prognostic independent of standard clinicopathologic factors. CALGB 9741 demonstrated improved recurrence-free (RFS) and overall survival (OS) with 2-weekly dose-dense (DD) versus 3-weekly therapy. A significant interaction between intrinsic subtypes and DD-therapy benefit was hypothesized. Suitable tumor samples were available from 1,471 (73%) of 2,005 subjects. Multiplexed gene-expression profiling generated the PAM50 subtype call, proliferation score, and risk of recurrence score (ROR-PT) for the evaluable subset of 1,311 treated patients. The interaction between DD-therapy benefit and intrinsic subtype was tested in a Cox proportional hazards model using two-sided alpha = 0.05. Additional multivariable Cox models evaluated the proliferation and ROR-PT scores as continuous measures with selected clinical covariates. Improved outcomes for DD therapy in the evaluable subset mirrored results from the complete data set (RFS; hazard ratio = 1.20; 95% confidence interval = 0.99–1.44) with 12.3-year median follow-up. Intrinsic subtypes were prognostic of RFS (P<0.0001) irrespective of treatment assignment. No subtype-specific treatment effect on RFS was identified (interaction P = 0.44). Proliferation and ROR-PT scores were prognostic for RFS (both P<0.0001), but no association with treatment benefit was seen (P = 0.14 and 0.59, respectively). Results were similar for OS. The prognostic value of PAM50 intrinsic subtype was greater than estrogen receptor/HER2 immunohistochemistry classification. PAM50 gene signatures were highly prognostic but did not predict for improved outcomes with DD anthracycline-and taxane-based therapy. Clinical validation studies will assess the ability of PAM50 and other gene signatures to stratify patients and individualize treatment based on expected risks of distant recurrence.

Original languageEnglish (US)
Article number15023
Journalnpj Breast Cancer
Volume2
Issue number1
DOIs
StatePublished - Dec 14 2016

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Anthracyclines
Breast Neoplasms
Drug Therapy
Genes
Therapeutics
Proportional Hazards Models
Recurrence
taxane
Survival
Validation Studies
Gene Expression Profiling
Estrogen Receptors
Immunohistochemistry
Confidence Intervals

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

Cite this

PAM50 gene signatures and breast cancer prognosis with adjuvant anthracycline-and taxane-based chemotherapy : Correlative analysis of C9741 (alliance). / Liu, Minetta C; Pitcher, Brandelyn N.; Mardis, Elaine R.; Davies, Sherri R.; Friedman, Paula N.; Snider, Jacqueline E.; Vickery, Tammi L.; Reed, Jerry P.; Deschryver, Katherine; Singh, Baljit; Gradishar, William J.; Perez, Edith A.; Martino, Silvana; Citron, Marc L.; Norton, Larry; Winer, Eric P.; Hudis, Clifford A.; Carey, Lisa A.; Bernard, Philip S.; Nielsen, Torsten O.; Perou, Charles M.; Ellis, Matthew J.; Barry, William T.

In: npj Breast Cancer, Vol. 2, No. 1, 15023, 14.12.2016.

Research output: Contribution to journalArticle

Liu, MC, Pitcher, BN, Mardis, ER, Davies, SR, Friedman, PN, Snider, JE, Vickery, TL, Reed, JP, Deschryver, K, Singh, B, Gradishar, WJ, Perez, EA, Martino, S, Citron, ML, Norton, L, Winer, EP, Hudis, CA, Carey, LA, Bernard, PS, Nielsen, TO, Perou, CM, Ellis, MJ & Barry, WT 2016, 'PAM50 gene signatures and breast cancer prognosis with adjuvant anthracycline-and taxane-based chemotherapy: Correlative analysis of C9741 (alliance)', npj Breast Cancer, vol. 2, no. 1, 15023. https://doi.org/10.1038/npjbcancer.2015.23
Liu, Minetta C ; Pitcher, Brandelyn N. ; Mardis, Elaine R. ; Davies, Sherri R. ; Friedman, Paula N. ; Snider, Jacqueline E. ; Vickery, Tammi L. ; Reed, Jerry P. ; Deschryver, Katherine ; Singh, Baljit ; Gradishar, William J. ; Perez, Edith A. ; Martino, Silvana ; Citron, Marc L. ; Norton, Larry ; Winer, Eric P. ; Hudis, Clifford A. ; Carey, Lisa A. ; Bernard, Philip S. ; Nielsen, Torsten O. ; Perou, Charles M. ; Ellis, Matthew J. ; Barry, William T. / PAM50 gene signatures and breast cancer prognosis with adjuvant anthracycline-and taxane-based chemotherapy : Correlative analysis of C9741 (alliance). In: npj Breast Cancer. 2016 ; Vol. 2, No. 1.
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abstract = "PAM50 intrinsic breast cancer subtypes are prognostic independent of standard clinicopathologic factors. CALGB 9741 demonstrated improved recurrence-free (RFS) and overall survival (OS) with 2-weekly dose-dense (DD) versus 3-weekly therapy. A significant interaction between intrinsic subtypes and DD-therapy benefit was hypothesized. Suitable tumor samples were available from 1,471 (73{\%}) of 2,005 subjects. Multiplexed gene-expression profiling generated the PAM50 subtype call, proliferation score, and risk of recurrence score (ROR-PT) for the evaluable subset of 1,311 treated patients. The interaction between DD-therapy benefit and intrinsic subtype was tested in a Cox proportional hazards model using two-sided alpha = 0.05. Additional multivariable Cox models evaluated the proliferation and ROR-PT scores as continuous measures with selected clinical covariates. Improved outcomes for DD therapy in the evaluable subset mirrored results from the complete data set (RFS; hazard ratio = 1.20; 95{\%} confidence interval = 0.99–1.44) with 12.3-year median follow-up. Intrinsic subtypes were prognostic of RFS (P<0.0001) irrespective of treatment assignment. No subtype-specific treatment effect on RFS was identified (interaction P = 0.44). Proliferation and ROR-PT scores were prognostic for RFS (both P<0.0001), but no association with treatment benefit was seen (P = 0.14 and 0.59, respectively). Results were similar for OS. The prognostic value of PAM50 intrinsic subtype was greater than estrogen receptor/HER2 immunohistochemistry classification. PAM50 gene signatures were highly prognostic but did not predict for improved outcomes with DD anthracycline-and taxane-based therapy. Clinical validation studies will assess the ability of PAM50 and other gene signatures to stratify patients and individualize treatment based on expected risks of distant recurrence.",
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T2 - Correlative analysis of C9741 (alliance)

AU - Liu, Minetta C

AU - Pitcher, Brandelyn N.

AU - Mardis, Elaine R.

AU - Davies, Sherri R.

AU - Friedman, Paula N.

AU - Snider, Jacqueline E.

AU - Vickery, Tammi L.

AU - Reed, Jerry P.

AU - Deschryver, Katherine

AU - Singh, Baljit

AU - Gradishar, William J.

AU - Perez, Edith A.

AU - Martino, Silvana

AU - Citron, Marc L.

AU - Norton, Larry

AU - Winer, Eric P.

AU - Hudis, Clifford A.

AU - Carey, Lisa A.

AU - Bernard, Philip S.

AU - Nielsen, Torsten O.

AU - Perou, Charles M.

AU - Ellis, Matthew J.

AU - Barry, William T.

PY - 2016/12/14

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N2 - PAM50 intrinsic breast cancer subtypes are prognostic independent of standard clinicopathologic factors. CALGB 9741 demonstrated improved recurrence-free (RFS) and overall survival (OS) with 2-weekly dose-dense (DD) versus 3-weekly therapy. A significant interaction between intrinsic subtypes and DD-therapy benefit was hypothesized. Suitable tumor samples were available from 1,471 (73%) of 2,005 subjects. Multiplexed gene-expression profiling generated the PAM50 subtype call, proliferation score, and risk of recurrence score (ROR-PT) for the evaluable subset of 1,311 treated patients. The interaction between DD-therapy benefit and intrinsic subtype was tested in a Cox proportional hazards model using two-sided alpha = 0.05. Additional multivariable Cox models evaluated the proliferation and ROR-PT scores as continuous measures with selected clinical covariates. Improved outcomes for DD therapy in the evaluable subset mirrored results from the complete data set (RFS; hazard ratio = 1.20; 95% confidence interval = 0.99–1.44) with 12.3-year median follow-up. Intrinsic subtypes were prognostic of RFS (P<0.0001) irrespective of treatment assignment. No subtype-specific treatment effect on RFS was identified (interaction P = 0.44). Proliferation and ROR-PT scores were prognostic for RFS (both P<0.0001), but no association with treatment benefit was seen (P = 0.14 and 0.59, respectively). Results were similar for OS. The prognostic value of PAM50 intrinsic subtype was greater than estrogen receptor/HER2 immunohistochemistry classification. PAM50 gene signatures were highly prognostic but did not predict for improved outcomes with DD anthracycline-and taxane-based therapy. Clinical validation studies will assess the ability of PAM50 and other gene signatures to stratify patients and individualize treatment based on expected risks of distant recurrence.

AB - PAM50 intrinsic breast cancer subtypes are prognostic independent of standard clinicopathologic factors. CALGB 9741 demonstrated improved recurrence-free (RFS) and overall survival (OS) with 2-weekly dose-dense (DD) versus 3-weekly therapy. A significant interaction between intrinsic subtypes and DD-therapy benefit was hypothesized. Suitable tumor samples were available from 1,471 (73%) of 2,005 subjects. Multiplexed gene-expression profiling generated the PAM50 subtype call, proliferation score, and risk of recurrence score (ROR-PT) for the evaluable subset of 1,311 treated patients. The interaction between DD-therapy benefit and intrinsic subtype was tested in a Cox proportional hazards model using two-sided alpha = 0.05. Additional multivariable Cox models evaluated the proliferation and ROR-PT scores as continuous measures with selected clinical covariates. Improved outcomes for DD therapy in the evaluable subset mirrored results from the complete data set (RFS; hazard ratio = 1.20; 95% confidence interval = 0.99–1.44) with 12.3-year median follow-up. Intrinsic subtypes were prognostic of RFS (P<0.0001) irrespective of treatment assignment. No subtype-specific treatment effect on RFS was identified (interaction P = 0.44). Proliferation and ROR-PT scores were prognostic for RFS (both P<0.0001), but no association with treatment benefit was seen (P = 0.14 and 0.59, respectively). Results were similar for OS. The prognostic value of PAM50 intrinsic subtype was greater than estrogen receptor/HER2 immunohistochemistry classification. PAM50 gene signatures were highly prognostic but did not predict for improved outcomes with DD anthracycline-and taxane-based therapy. Clinical validation studies will assess the ability of PAM50 and other gene signatures to stratify patients and individualize treatment based on expected risks of distant recurrence.

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