Abstract

ABSTRACT Aim: The Recurrence Score (RS) predicts outcome in node- and node + , ER+ pts treated with endocrine therapy and chemotherapy (CT) benefit. We studied the prognostic impact of the RS in node + , HR+ pre and post-menopausal pts treated with adjuvant chemohormonal therapy in PACS01 and here present an analysis of the performance of the RS in pre- and post-menopausal pts. Methods: PACS01 compared FEC with FEC-D in 1999 pts. The current study included 530 pts from the PACS01 parent trial who were central IHC HR+ with sufficient tissue for Oncotype DX. Primary objective was to estimate the association between RS and distant recurrence free interval (DRFI). Secondary endpoints included disease free survival (DFS) and overall survival (OS). Herein we explore the association of the RS in pre- and post-menopausal women. Median follow-up time was 7.7 yrs. Results: Of 530 pts, 317 were pre-menopausal and 205 were post-menopausal - 209 (39.4%) had low; 159 (30.0%) intermediate; and 162 (30.6%) high RS. Of pre-menopausal, 124 (39.1%) had low; 89 (28.1%) intermediate & 104 (32.8%) high RS. Of post-menopausal 84 (41.0%) had low, 68 (33.2%) intermediate & 53 (25.9%) high RS. 74.2% were treated with tam. In the primary analysis, RS was a significant predictor of DRFI (HR= 4.1 for a 50 point difference, P RS Low RS Int RS High Log-rank p-value All pts n = 530 93.7 (89.4–96.3) 87.3 (81.0–91.6) 69.3 (61.5–75.8) p Pre-meno n = 317 93.5 (87.4–96.7) 89.8 (81.3–94.5) 70.9 (61.1–78.7) p Post-meno n = 205 94.0 (86.2–97.5) 85.2 (74.2–91.7) 64.9 (50.2–76.3) p Conclusions: The 21-gene RS was prognostic in HR + , node+ pts treated with FEC or FEC-D adjuvant CT and the performance was similar in pre- and post-menopausal pts. The data is consistent with those presented from B28 providing further supportive evidence for the assay's validity in pre-menopausal, node+ pts. Disclosure: F. Penault-Llorca: I have an advisory relationship with Genomic Health Inc, and receive speaker's honoraria from Genomic Health, Inc.; F. Baehner: Frederick Baehner is an employee of Genomic Health, Inc.; P. Fumoleau: Dr Fumoleau has an consultant/advisory relationship with Sanofi, Roche and Novartis. S. Butler: Mr. Butler is an employee of Genomic Health, Inc.; F. Jamshidian: Mr Jamshidian is an employee of Genomic Health, Inc.; D. Cherbavaz: Mrs Cherbavaz is an employee of Genomic Health, Inc. All other authors have declared no conflicts of interest.

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