Abstract P2-08-01: Validation of a 16-gene genomic signature to identify early-stage invasive breast cancer patients who may omit radiotherapy
Bibliographic record
Abstract
Abstract Background While whole breast radiotherapy has been standard of care for invasive breast cancer patients treated with breast conserving surgery, not all women may benefit from radiotherapy. Recently, we demonstrated that a 16-gene signature named Profile for the Omission of Local Adjuvant Radiotherapy (POLAR) could identify breast cancer patients with HR+, HER2- tumors treated with breast conserving surgery alone with a 10-year locoregional recurrence risk of less than 10%. Methods In this study, we apply the signature to patients enrolled in the Princess Margaret Trial, a randomized trial where patients age 50 years or older were randomized to radiotherapy and tamoxifen or tamoxifen alone after breast conserving surgery. Tissue from 132 patients with HR+, HER2- tumors were available for gene expression analysis. Results For women treated with tamoxifen alone after breast conserving surgery, POLAR identified low risk women with a 7% risk of locoregional recurrence at 10 years. Comparison to POLAR-low patients treated with adjuvant radiotherapy did not demonstrate a significant benefit from radiotherapy (HR=1.5[0.14-16], p=0.74). POLAR-high patients not treated with radiotherapy had a 22% risk of locoregional recurrence at 10 years. Comparison to POLAR-high patients treated with adjuvant radiotherapy demonstrated a significant benefit from standard radiotherapy (HR=0.25[0.07-0.92], p=0.038). Conclusions These data suggest that the POLAR genomic signature may be used to identify patients with a low risk of locoregional recurrence without significant benefit from adjuvant radiotherapy. Patients with low POLAR scores may potentially be candidates for radiation therapy omission when treated with breast conserving surgery and tamoxifen. Citation Format: Anthony Fyles, S. Laura Chang, Katrina Rey-McIntyre, Wei Shi, Felix Feng, Corey Speers, Lori Pierce, David McCready, Fei-Fei Liu. Validation of a 16-gene genomic signature to identify early-stage invasive breast cancer patients who may omit radiotherapy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-08-01.
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How this classification was reachedexpand
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) | 0.001 | 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) | 0.002 | 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, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".