Evaluation of the OncoMasTR prognostic signature in postmenopausal women with primary ER-positive breast cancer.
Bibliographic record
Abstract
553 Background: The assessment of distant recurrence (DR) risk in patients with early estrogen receptor (ER) positive breast cancer receiving adjuvant endocrine therapy is essential in making decisions on additional treatment. OncoMasTR (OM) is a continuous risk prediction model that provides a quantitative assessment of the likelihood of DR in patients with ER-positive breast cancer. The aim of this study was to assess the prognostic performance of OM in predicting DR for postmenopausal patients treated with anastrozole or tamoxifen. Methods: OM incorporates three genes and was developed in an endocrine treated population. OMclinical incorporates clinical parameters into the molecular OM. OM was evaluated for 648 ER-positive, HER2-negative patients with 0 to 3 involved lymph nodes in the TransATAC cohort. DR was the primary endpoint. Cox regression models were used to assess the prognostic performance. OM was evaluated for the overall time period and secondarily for late DR (years 5-10), and in node-negative and node-positive patients separately. Results: OM and OMclinical were highly prognostic for the prediction of DR in years 0-10 among all patients (LRχ2= 25.43 and LRχ2= 48.73, respectively, P < 0.001). OM/OMclinical provided significant additional prognostic value beyond standard clinicopathological variables. In women with node-negative disease, OM identified 37.8% of women as low risk with a 10-year DR risk of 3.5% (1.6-7.7), which was significantly lower compared to those categorised as high risk (10-year DR risk: 16.4% (12.4-21.5); HR = 4.8 (2.0-11.2)). Similar risk stratification and 10-year DR risks were observed for OMclinical in women with node-negative disease (HR = 6.5 (2.6-16.3)). Little prognostic information was provided for node-positive patients. OM and OMclinical were also highly prognostic for the prediction of late DR (LRχ2= 12.84 and LRχ2= 25.61, respectively, P < 0.001). Conclusions: OM and OMclinical were highly prognostic for early and late DR in women with early-stage (particularly node-negative) ER-positive breast cancer receiving 5 years of endocrine therapy and merit further evaluation as risk stratifiers to identify women who can safely forego chemotherapy.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Other design | low |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".