signature=f191be7b8de71aa3fe6ad41388674d47,Abstract #1894: The 70-gene MammaPrint(R) signature predi...

摘要：

Preoperative (\\#8216;neoadjuvant\\#8217;) chemotherapy is frequently employed in stage II and III breast cancer. A pathological complete remission (pCR) is predictive of a favorable prognosis and is viewed as a surrogate for chemotherapy sensitivity. A pCR, here defined as the complete absence of infiltrating tumor cells at microscopic examination of both the breast and the axilla, is more often achieved in higher grade tumors and it is relatively rare in ER+/HER2- tumors. The MammaPrint® 70-gene expression signature has been shown to accurately predict prognosis in early breast cancer. To assess the potential predictive power of the 70-gene signature, we studied a consecutive series of 167 patients who received neoadjuvant chemotherapy for stage II or III breast cancer and whose pretreatment tumor samples contained sufficient tumor cells and had yielded RNA of adequate quality for analysis. Of these tumors, only 23 (14%) had a good prognosis signature (GPS), consistent with the fact that the group predominantly consisted of patients with locally advanced disease (stage III). Of the 144 patients in the poor prognosis signature (PPS) group, 29 (20%) achieved a pCR, whereas none of the patients with a GPS (0/23) did (P=0.015). All triple-negative (TN) tumors (ER-, PR- and HER2-) had a PPS. ER+/HER2- tumors and HER2+ tumors had a GPS in 24% (21/88) and 5% (2/41) of cases, respectively. Even when the TN-tumors were excluded from the analysis, the degree of shrinkage of the primary breast tumor continued to be associated with the outcome of the 70-gene signature (P=0.015) with less decrease in size among the GPS tumors (table). Nevertheless, after a median follow-up of 25 months, 19 relapses were seen in the poor signature and none in the good signature group. These findings indicate that a pCR is unlikely to be achieved in tumors that have a good prognosis 70-gene signature and that, at least in the neoadjuvant setting, tumors with a PPS are more sensitive to chemotherapy than those with a GPS. $$table_{595E6032-71ED-46B4-8D94-012226C7BA91}$$ Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. nr 1894.

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