Chemotherapy response and recurrence-free survival in neoadjuvant breast cancer depends on biomarker profiles: results from the I-SPY 1 TRIAL (CALGB 150007/150012; ACRIN 6657).
Chemotherapy response and recurrence-free survival in neoadjuvant breast cancer depends on biomarker profiles: results from the I-SPY 1 TRIAL (CALGB 150007/150012; ACRIN 6657).
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DOI：
10.1007/s10549-011-1895-2
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发表时间：
2012-04
影响因子：
3.8
通讯作者：
Hylton, Nola
中科院分区：
文献类型：
--
作者：
Esserman, Laura J.;Berry, Donald A.;Cheang, Maggie C. U.;Yau, Christina;Perou, Charles M.;Carey, Lisa;DeMichele, Angela;Gray, Joe W.;Conway-Dorsey, Kathleen;Lenburg, Marc E.;Buxton, Meredith B.;Davis, Sarah E.;van't Veer, Laura J.;Hudis, Clifford;Chin, Koei;Wolf, Denise;Krontiras, Helen;Montgomery, Leslie;Tripathy, Debu;Lehman, Constance;Liu, Minetta C.;Olopade, Olufunmilayo I.;Rugo, Hope S.;Carpenter, John T.;Livasy, Chad;Dressler, Lynn;Chhieng, David;Singh, Baljit;Mies, Carolyn;Rabban, Joseph;Chen, Yunni-Yi;Giri, Dilip;Au, Alfred;Hylton, Nola
乳腺癌的新辅助化疗允许根据分子亚型评估个体肿瘤反应，并判断治疗反应对无复发生存期（RFS）的影响。多中心I-SPY 1试验通过使用早期成像和分子特征评价了肿瘤≥3 cm的患者，结局为病理完全缓解（pCR）和RFS。当前的分析使用了具有分子特征但未接受曲妥珠单抗治疗的患者的数据。测试的各种分子分类器高度相关。与整个人群相比，通过分子特征对乳腺癌进行分类增强了pCR预测RFS改善的能力。在多变量分析中，增加HR和HER 2受体、临床分期和pCR预测RFS能力的分子特征包括70基因特征、伤口愈合特征、p53突变特征和PAM 50复发风险。低风险特征与显著更好的预后相关，并且还在无pCR组中鉴定了具有良好预后的其他患者，主要是在激素受体阳性、HER-2阴性亚组中。I-SPY 1人群富含预后不良的肿瘤，但在pCR和RFS率方面仍不均匀。pCR预测RFS的能力在亚组中优于整个组。分子标志物通过在无pCR组中识别具有良好预后的额外患者来改善RFS的预测。本文的在线版本（doi：10.1007/s10549-011-1895-2）包含补充材料，可供授权用户使用。
Neoadjuvant chemotherapy for breast cancer allows individual tumor response to be assessed depending on molecular subtype, and to judge the impact of response to therapy on recurrence-free survival (RFS). The multicenter I-SPY 1 TRIAL evaluated patients with ≥3 cm tumors by using early imaging and molecular signatures, with outcomes of pathologic complete response (pCR) and RFS. The current analysis was performed using data from patients who had molecular profiles and did not receive trastuzumab. The various molecular classifiers tested were highly correlated. Categorization of breast cancer by molecular signatures enhanced the ability of pCR to predict improvement in RFS compared to the population as a whole. In multivariate analysis, the molecular signatures that added to the ability of HR and HER2 receptors, clinical stage, and pCR in predicting RFS included 70-gene signature, wound healing signature, p53 mutation signature, and PAM50 risk of recurrence. The low risk signatures were associated with significantly better prognosis, and also identified additional patients with a good prognosis within the no pCR group, primarily in the hormone receptor positive, HER-2 negative subgroup. The I-SPY 1 population is enriched for tumors with a poor prognosis but is still heterogeneous in terms of rates of pCR and RFS. The ability of pCR to predict RFS is better by subset than it is for the whole group. Molecular markers improve prediction of RFS by identifying additional patients with excellent prognosis within the no pCR group. The online version of this article (doi:10.1007/s10549-011-1895-2) contains supplementary material, which is available to authorized users.
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影响因子：
11.5
作者：
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