Abstract P6-09-20: Clinical utility of PgR with various cutpoints using 3 commercial assays relative to 15yr survival
Notice bibliographique
Résumé
Abstract Introduction: Hormone receptors ER and PgR are routinely assessed by pathologists using immunohistochemical (IHC) assays to guide treatment decisions. Patients who are hormone receptor positive are offered hormonal therapy, such as tamoxifen, which improves survival. Although both ER and PgR are evaluated, ER is primarily utilized for patient management as the clinical utility of PgR has not been clearly established according to CAP/ASCO guidelines. Notably, a meta-analysis by the Early Breast Cancer Trialists' Collaborative Group reported that PgR status was not significantly predictive of response to adjuvant tamoxifen, suggesting that PgR may not have a role in breast cancer management. More recently, the level of PgR expression has been hypothesized to be important in predicting response to endocrine therapy, where high PgR levels are more indicative of estrogen-dependent tumors, and thus more sensitive to hormonal treatment. In this study, we evaluate PgR expression using the current cut-point (Allred>2), as well as an optimized cut-point (Allred>5 to identify PgR high tumors), with regards to 15yr disease-free survival (DFS) and disease-specific overall survival (DSOS) using three commercially available ready-to-use (RTU) IHC assays from Dako, Leica and Ventana in an ER+ cohort. Methods: The Calgary tamoxifen breast cancer cohort (Calgary cohort) is a TMA series that includes 532 patients diagnosed with primary breast cancer (1985-2000) who received tamoxifen treatment regardless of hormone receptor status. All RTU assays followed vendor recommended protocols. Specific details regarding the cohort and IHC assays have been previously described (Kornaga et al. Mod Path 2016). All analyses were performed using Stata 12, and multivariate models were adjusted for age, grade, size, lymph node and HER2 status. ER status was defined by the corresponding vendor specific IHC assay. Results: Multivariate models looking at DFS are presented in Table 1. None of the assays were significant when the clinical cut-point was used; however, when the optimized cut-point was investigated, all assays found high expression of PgR was significantly associated with improved DFS. Table 2 presents the multivariate models looking at DSOS. Similarly, PgR was not found to be associated with improved DSOS using the current cut-point. When the optimized cut-point was examined, Dako and Leica assays were significantly associated with improved DSOS: The Ventana assay did not reach significance. Table 1 PgR15YR DFS CutpointHR95% CIp-valueDako>20.830.40-1.730.624Dako>50.560.35-0.910.020Leica>21.130.45-2.830.792Leica>50.520.30-0.890.017Ventana>20.730.32-1.670.460Ventana>50.570.34-0.970.037 Table 2 PgR15YR DSOS CutpointHR95% CIp-valueDako>20.740.33-1.650.464Dako>50.550.32-0.950.031Leica>20.880.35-2.220.780Leica>50.440.24-0.790.006Ventana>20.590.25-1.370.218Ventana>50.630.35-1.150.134 Conclusions: High PgR expression (Allred>5) is associated with improved 15yr DFS and DSOS in a tamoxifen-treated cohort, where PgR positivity defined using current guidelines is not associated with improved DFS or DSOS. Additionally, differences were noted between the vendor RTU assays with regards to DSOS. Citation Format: Kornaga EN, Paterson AHG, Feng X, Morris DG, Magliocco AM, Klimowicz AC. Clinical utility of PgR with various cutpoints using 3 commercial assays relative to 15yr survival [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-20.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
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 tête enseignante, 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 ».