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Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
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Related Experiment Video

Updated: Jun 15, 2025

Establishing a Competing Risk Regression Nomogram Model for Survival Data
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Clinical Treatment Score Post-5 Years (CTS5) and Late Recurrence Risk in Hormone Receptor-Positive, HER2-Positive

Saranya Chumsri1, Tanmayi Pai1, Yaohua Ma2

  • 1Mayo Clinic Florida, Jacksonville, FL.

Journal of the National Comprehensive Cancer Network : JNCCN
|August 27, 2024
PubMed
Summary

The Clinical Treatment Score post-5 years (CTS5) is not effective for predicting late recurrence in HER2-positive breast cancer treated with trastuzumab. New models are needed for this patient group.

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Area of Science:

  • Oncology
  • Clinical Trials
  • Breast Cancer Research

Background:

  • The Clinical Treatment Score post-5 years (CTS5) is a validated tool for risk stratification of late recurrence in hormone receptor-positive (HR+), HER2-negative breast cancer (BC).
  • Limited data exist regarding the efficacy of CTS5 in HR+, HER2-positive (HER2+) BC.

Purpose of the Study:

  • To evaluate the performance of the CTS5 score in predicting late recurrence in patients with HR+, HER2+ BC.
  • To assess the association of CTS5 with recurrence-free survival (RFS) in this specific patient population.

Main Methods:

  • Analysis of data from 1,862 patients with HR+, HER2+ BC from the NCCTG N9831 and NSABP B-31 clinical trials.
  • Evaluation of CTS5 score and its components against RFS in patients who received adjuvant trastuzumab.

Main Results:

  • The CTS5 score was significantly associated with RFS overall (HR, 1.35; P=.002) but not in patients receiving trastuzumab (HR, 1.29; P=.07).
  • CTS5 risk categories did not significantly correlate with RFS. Paradoxically, higher tumor grade was linked to better outcomes (HR, 0.71; P=.05).
  • Late recurrences (5-10 years) occurred in 10.6% of low-risk, 5.6% of intermediate-risk, and 9.8% of high-risk CTS5 categories.

Conclusions:

  • The CTS5 model is not a reliable predictor of late recurrence in HR+, HER2+ BC patients treated with adjuvant trastuzumab.
  • There is a critical need for developing novel prognostic models tailored for HR+, HER2+ BC patients receiving trastuzumab therapy to better predict late recurrence risk.