Prognostic value of the 6-gene OncoMasTR test in hormone receptor–positive HER2-negative early-stage breast cancer: Comparative analysis with standard clinicopathological factors

Seodhna M. Lynch, Niamh M. Russell, Stephen Barron, Chan-ju A. Wang, Tony Loughman, Peter Dynoodt, Bozena Fender, Cesar Lopez-ruiz, Anthony O'grady, Katherine M. Sheehan, Joanna Fay, Verena Amberger-murphy, Anurati Saha, Rut Klinger, Claudia A. Gonzalez, Nebras Al-attar, Arman Rahman, Desmond O'leary, Fiona T. Lanigan, Adrian P. BrackenJohn Crown, Catherine M. Kelly, Darran P. O'connor, William M. Gallagher

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Aim: The aim of the study was to assess the prognostic performance of a 6-gene
molecular score (OncoMasTR Molecular Score [OMm]) and a composite risk score (OncoMasTR Risk Score [OM]) and to conduct a within-patient comparison against four routinely used molecular and clinicopathological risk assessment tools: Oncotype DX Recurrence Score, Ki67, Nottingham Prognostic Index and Clinical Risk Category, based on the modified Adjuvant! Online definition and three risk factors: patient age, tumour size and grade.
Methods: Biospecimens and clinicopathological information for 404 Irish women also previously enrolled in the Trial Assigning Individualized Options for Treatment [Rx] were provided by 11 participating hospitals, as the primary objective of an independent translational study. Gene expression measured via RT-qPCR was used to calculate OMm and OM. The prognostic value for distant recurrence-free survival (DRFS) and invasive disease-free survival (IDFS) was assessed using Cox proportional hazards models and Kaplan-Meier analysis.
All statistical tests were two-sided ones.
Results: OMm and OM (both with likelihood ratio statistic [LRS] P < 0.001; C
indexes Z 0.84 and 0.85, respectively) were more prognostic for DRFS and provided significant additional prognostic information to all other assessment tools/factors assessed (all LRS P 0.002). In addition, the OM correctly classified more patients with distant recurrences (DRs) into the high-risk category than other risk classification tools. Similar results were observed for IDFS.
Discussion: Both OncoMasTR scores were significantly prognostic for DRFS and IDFS and provided additional prognostic information to the molecular and clinicopathological risk factors/tools assessed. OM was also the most accurate risk classification tool for identifying DR. A concise 6-gene signature with superior risk stratification was shown to increase prognosis reliability, which may help clinicians optimise treatment decisions.
Original languageEnglish
Pages (from-to)78-89
Number of pages12
JournalEuropean Journal of Cancer
Volume152
Early online date2 Jun 2021
DOIs
Publication statusPublished - 1 Jul 2021

Keywords

  • Breast cancer
  • ER+/HER2-
  • Prognostic biomarker
  • Recurrence score

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