Utility of the CPS plus EG staging system in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer treated with neoadjuvant chemotherapy
Utility of the CPS plus EG staging system in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer treated with neoadjuvant chemotherapy
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DOI：
10.1016/j.ejca.2015.09.022
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发表时间：
2016-01-01
影响因子：
8.4
通讯作者：
Schneeweiss, Andreas
中科院分区：
文献类型：
--
作者：
Marme, Frederik;Lederer, Bianca;Schneeweiss, Andreas
背景：原发性乳腺癌新辅助化疗后病理完全缓解（NACT）与总生存期（OS）相关。最近描述了一种基于治疗前临床分期（CS）、最终病理分期（PS）、雌激素受体（ER）状态和核分级（NG）的分期系统，可以精确估计未选择患者的预后。它在腔型乳腺癌中的作用尚未确定。本研究调查了CPS + EG评分在激素受体阳性(HR+)/人表皮生长因子受体2阴性（HER2-）患者中的临床应用，并将结果与未选择的患者进行了比较。方法：在8项前瞻性德国试验中，计算6637名未选择的患者和2454名接受蒽环类/紫杉烷类NACT治疗的HR +/HER2-肿瘤患者的CPS + EG评分。结果：未选择队列的5年无病生存（DFS）和OS分别为75.6%和84.1%，hr +/HER2-亚组的5年无病生存（DFS）和OS分别为80.6%和87.8%。CPS + EG系统区分不同的预后组，5年DFS从0%到91%不等。与单独的CS、PS、ER或NG相比，CPS + EG系统可以根据结果对患者进行更好的分类。当将CPS + EG评分应用于HR +/HER2-亚组时，与总体人群相比，观察到得分较低，但个体得分的5年DFS和OS与总体人群观察到的相同。结论：在hr +/HER2-患者中，CPS + eg分期系统保留了根据结果对患者进行精细分层的能力。它可以帮助在腔内乳腺癌的新辅助后临床试验中选择候选人。(C) 2015 Elsevier Ltd.版权所有。
Background: Pathologic complete response after neoadjuvant chemotherapy (NACT) correlates with overall survival (OS) in primary breast cancer. A recently described staging system based on pre-treatment clinical stage (CS), final pathological stage (PS), estrogen receptor (ER) status and nuclear grade (NG) leads to a refined estimation of prognosis in unselected patients. Its performance in luminal type breast cancers has not been determined. This study investigates the clinical utility of this CPS + EG score when restricted to hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) patients and compares the results to a cohort of unselected patients.Methods: The CPS + EG score was calculated for 6637 unselected patients and 2454 patients with HR +/HER2- tumours who received anthracycline/taxane-based NACT within 8 prospective German trials.Results: Five-year disease-free survival (DFS) and OS were 75.6% and 84.1% for the unselected cohort and 80.6% and 87.8% for theHR +/HER2- subgroup, respectively. The CPS + EG system distinguished different prognostic groups with 5-year DFS ranging from 0% to 91%. The CPS + EG system leads to an improved categorisation of patients by outcome compared to CS, PS, ER or NG alone. When applying the CPS + EG score to the HR +/HER2- subgroup, a shift to lower scores was observed compared to the overall population, but 5-year DFS and OS for the individual scores were identical to that observed in the overall population.Conclusions: InHR +/HER2- patients, the CPS + EGstaging system retains its ability to facilitate a refined stratification of patients according to outcome. It can help to select candidates for post-neoadjuvant clinical trials in luminal breast cancer. (C) 2015 Elsevier Ltd. All rights reserved.