Abstract P6-05-07: Discordance in estrogen receptor, progesterone receptor and HER-2/neu status between primary and metastatic breast cancer: A systematic review
Notice bibliographique
Résumé
Abstract BACKGROUND AND OBJECTIVE Systemic treatment choices for metastatic breast cancer are based, in part, on the estrogen receptor (ER), progesterone receptor (PR), and epidermal growth factor receptor (HER2) status of the primary cancer. Receptor discordance between primary and associated metastases is well recognized and could have important therapeutic implications. A systematic review of all relevant studies was conducted to assess the extent of discordance in ER, PR and HER2 status between primary breast cancers and their paired metastases. METHODS A search was performed using EMBASE (1980-2013), Medline (1966-2013) and Cochrane Central Register of Controlled Trials (CENTRAL, 2013 issue 1), references of included studies, relevant review articles and conference abstracts. Only English-language cohort studies reporting ER, PR, and HER2 expression for matching primary breast cancer and metastatic sites were eligible. Title and abstract screening was performed by one reviewer; full text articles of potentially relevant citations were independently screened by two reviewers. Using pre-defined criteria, two reviewers performed data extraction of the included studies, as well as methodologic quality assessment (QUADAS-2) and risk of bias assessment. Disagreements by reviewers were adjudicated by consensus. Median discordance and interquartile range (IQR) of discordance of each of the biomarkers (ER, PR, HER2) between primary breast cancer and their paired metastases were calculated. Association between receptor discordance and site of metastasis site was also explored. RESULTS Of the 5034 citations identified, 58 studies (representing a total of 3,522 matched primary and metastatic pairs) met our inclusion criteria. Studies were generally small, as reflected by the median number of matched pairs of 42 (range 4-370). Median discordance rates between primary and paired metastases were 18% (IQR10–29%) for ER, 23% (IQR16–43%) for PR and 9% (IQR 4–14%) for HER2 respectively. Discordance rates were higher if the metastatic site was a lymph node [ER: 42% (42–60%); PR: 48% (46–50%); HER2: 25% (11–38%)] as compared to all other sites of disease (e.g. bone marrow, lung, liver and brain) [ER: 25% (14-42%); PR: 36%(19-45)%; HER2: 13% (5-21%)]. Overall, receptor loss was more common than receptor gain across all metastatic sites. CONCLUSION This is the first systematic review we are aware of, that evaluates the extent, direction, and relationship of ER, PR and HER2 discordance between primary breast cancer and their paired metastases. Discordance varied from 10-60% depending on the receptor type and site of metastasis. When discordance occurs, loss of a biomarker is most common and most frequent with PR. These results could have important therapeutic implications in the treatment of recurrent and metastatic breast cancer. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-07.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,017 | 0,076 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,013 | 0,009 |
| Bibliométrie | 0,012 | 0,012 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».