Abstract
Abstract Background: Recently, EPclin, a second generation multigene test has been introduced into clinical practice. Aim of this prospective study is to compare conventional clinicopathological factors, uPA/PAI-1 and EPclin and to determine, how these parameters influence adjuvant treatment decisions. Methods: 217 consecutive cases of ER-pos, HER2neg, breast cancer cases were enrolled in this study. Conventional clinicopathological factors, uPA/PAI-1 and EPclin were obtained by central pathology assessment of the patients' surgical specimen. Decision for type of adjuvant treatment was made twice – once with and once without EPclin result- after case discussion in an interdisciplinary tumor conference. Results: 217 Patients (pt) have been evaluated. Tumor grading within the presented cohort was as follows: G1: 44 pt (20%), G2: 146 pt (68%), G3: 27 pt (12%). 59 pt (27%) had positive axillary lymph node involvement. 57 pt (26%) were pT1a/b. EPclin could be assessed in all patients. 85 pt (39%) were classified as "high risk" whereas 132 pt (61%) were classified as "low risk". uPA/PAI was obtained from 123 pt (57%). 64 pt (52%) out of these had high uPA/PAI-1 levels whereas 59 pt (48%) showed low uPA/PAI-1 levels. Level of progesterone receptor (PR) expression was obtained from 216 pt. 39 pt (18%) had low or absent PR expression (PR ≤ 20%). 26 pt (67%) of this low PR expression group were classified as EPclin high risk. Furthermore 118 pt (67%) of the high PR expression group (177 pt) were classified as "low risk" via EPclin (p<0,0001). In 89 cases (41%) treatment decision was influenced by EPclin: In 73pt (34%) adjuvant chemotherapy (ctx) was omitted whereas in 16 pt (7%) ctx was added following the EPclin result. Conclusions: This prospective study shows for the first time, that PR expression is strongly associated with risk score evaluated by EPclin testing. In comparison with uPA/PAI-1 and conventional clinicopathological factors EPclin is the more powerful tool to help reduce unnecessary adjuvant chemotherapy. Citation Format: Johannes Ettl, Kirsten Große Lackmann, Alexander Hapfelmeier, Evelyn Klein, Stefan Paepke, Christoph Petry, Katja Specht, Laura Wolff, Heinz Höfler, Marion Kiechle. Prospective comparison of conventional clinicopathological factors, uPA/PAI-1 and EndoPredict®-clin score (EPclin) for adjuvant clinical decision making in ER-positive, HER2-negative breast cancer: Progesterone receptor expression is strongly associat [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-11-27.
Published Version
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