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Recurrence score-predicted value derived from estrogen receptor, tumor-infiltrating lymphocytes, progesterone receptor, and Ki-67 may substitute for the Oncotype DX recurrence score in estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)- breast cancer

  • 0Department of Breast and Thyroid Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Annals of Diagnostic Pathology +

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November 23, 2024

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November 23, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

A new formula using estrogen receptor (ER), tumor-infiltrating lymphocytes (TILs), progesterone receptor (PgR), and Ki-67 can predict recurrence scores (RS) for ER+/HER2- breast cancer, offering a cost-effective alternative to Oncotype DX.

Area Of Science

  • Oncology
  • Genomics
  • Biostatistics

Background

  • The Oncotype DX assay is a standard tool for predicting prognosis and chemotherapy benefit in ER+/HER2- breast cancer.
  • High costs limit Oncotype DX accessibility for many patients.
  • There is a need for cost-effective alternatives to predict recurrence scores (RS).

Purpose Of The Study

  • To develop and validate an alternative RS prediction formula using readily available clinicopathological factors.
  • To identify optimal factors for predicting Oncotype DX RS in ER+/HER2- breast cancer.

Main Methods

  • Retrospective review of 81 ER+/HER2- breast cancer patients with measured Oncotype DX RS.
  • Stepwise multivariate linear regression analysis on 60 training cases using factors like ER, PgR, Ki-67, and TILs.
  • Validation of the derived RS prediction formula on 21 independent cases.

Main Results

  • A formula combining ER, TILs, PgR, and Ki-67 achieved a significant correlation (r=0.731103, p=0.0002) with Oncotype DX RS.
  • The model explained 51.0013% of the variance in Oncotype DX RS (adjusted R²).
  • The derived RS showed high concordance (95.2%) and agreement (kappa=0.829) with Oncotype DX RS when using a threshold of 26 for chemotherapy decisions.

Conclusions

  • A novel RS prediction formula utilizing ER, TILs, PgR, and Ki-67 demonstrates strong correlation and concordance with Oncotype DX RS.
  • This clinicopathological factor-based formula may serve as a viable and cost-effective substitute for Oncotype DX RS in specific clinical scenarios.
  • Further validation in larger, diverse cohorts is warranted to confirm its utility in guiding treatment decisions.

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