Long-term prospective outcome data using EndoPredict as risk stratification and chemotherapy decision biomarker in hormone receptor-positive, HER2-negative early breast cancer

Evelyn Klein ¹, Marion Kiechle ², Adriana Josipovic ²

⁰Department of Obstetrics and Gynecology, Klinikum rechts der Isar, School of Medicine and Health, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. evelyn.klein@tum.de.

Breast Cancer Research and Treatment +

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May 9, 2024

View abstract on PubMed

Summary

The EndoPredict test effectively identifies early breast cancer patients at high risk for recurrence, guiding chemotherapy decisions. This genomic test is valuable for both premenopausal and postmenopausal women, improving treatment strategies.

Area Of Science

Oncology
Genomics
Clinical Trial Analysis

Background

Adjuvant chemotherapy decisions in early-stage breast cancer are critical for patient outcomes.
Genomic assays like EndoPredict offer personalized risk assessment to optimize treatment selection.
Long-term outcome data is essential for validating the clinical utility of such genomic tests.

Purpose Of The Study

To evaluate the prospective long-term outcomes of early breast cancer patients whose treatment decisions were informed by the EndoPredict genomic test.
To assess the association of EndoPredict-based risk stratification with disease-free survival and distant metastasis-free survival over a median follow-up of 8.2 years.

Main Methods

A cohort of 368 patients with hormone receptor-positive, HER2-negative early breast cancer and 0-3 positive lymph nodes were analyzed.
The EndoPredict test was performed on all tumor samples to stratify patients into low-risk and high-risk groups.
Treatment compliance, local recurrence, distant metastases, survival rates, and time-to-event analyses were used to evaluate outcomes.

Main Results

EndoPredict classified 65% of patients as low-risk and 35% as high-risk.
High-risk patients demonstrated a twofold higher risk of recurrence or death (HR 2.08) compared to low-risk patients.
Five-year disease-free survival was 95.3% for low-risk and significantly lower for high-risk patients (89.1% with chemotherapy vs. 68.9% without).
High-risk stratification was associated with increased risk of distant metastasis or death, irrespective of menopausal status.

Conclusions

The EndoPredict test is a reliable tool for guiding adjuvant chemotherapy decisions in early luminal breast cancer.
EndoPredict risk stratification is applicable and beneficial for both premenopausal and postmenopausal women.
Long-term outcome data supports the clinical utility of EndoPredict in personalized breast cancer management.

Keywords:

Adjuvant chemotherapy Breast cancer EndoPredict Predictive biomarker Prognostic biomarker Risk stratification

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