Molecular subtyping of early-stage breast cancer identifies a group of patients who do not benefit from neoadjuvant chemotherapy
The aim of this study was to analyze the correlation between the pathologic complete response (pCR) rate after neoadjuvant chemotherapy and long-term outcome (distant metastases-free survival [DMFS]) in patients with early-stage breast cancer using BluePrint and MammaPrint molecular subtyping versus...
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| Veröffentlicht in: | Breast cancer research and treatment 2013-06, Vol.139 (3), p.759-767 |
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| creator | Glück, Stefan de Snoo, Femke Peeters, Justine Stork-Sloots, Lisette Somlo, George |
| description | The aim of this study was to analyze the correlation between the pathologic complete response (pCR) rate after neoadjuvant chemotherapy and long-term outcome (distant metastases-free survival [DMFS]) in patients with early-stage breast cancer using BluePrint and MammaPrint molecular subtyping versus clinical subtyping using immunohistochemistry/fluorescence in situ hybridization (IHC/FISH) for the determination of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (HER2). Data were analyzed from 437 patients in four neoadjuvant chemotherapy trials. BluePrint and MammaPrint outcomes were determined from 44K Agilent arrays, the I-SPY 1 data portal, or Affymetrix U133A arrays. The pCR rate differed substantially among BluePrint molecular subgroups: 6 % in Luminal A-type, 10 % in Luminal B-type, 47 % in HER2-type, and 37 % in Basal-type patients. In the Luminal A-type group (
n
= 90; including seven HER2-positive patients and eight triple-negative patients by IHC/FISH), the 5-year DMFS rate was 93 %. The pCR rate provided no prognostic information, suggesting these patients may not benefit from chemotherapy. Forty-three of 107 (40 %) HER2-positive patients were classified as Luminal-type by BluePrint and may have lower response rates to targeted therapy. Molecular subtyping identified 90 of 435 (21 %) patients as Luminal A-type (BluePrint Luminal-type/MammaPrint Low Risk) with excellent survival. The pCR rate provided no prognostic information. Molecular subtyping can improve the stratification of patients in the neoadjuvant setting: Luminal A-type (MammaPrint Low Risk) patients have a good prognosis with excellent survival and do not seem to benefit from chemotherapy. We observed marked benefit in response and DMFS to neoadjuvant treatment in patients subtyped as HER2-type and Basal-type. BluePrint with MammaPrint molecular subtyping helps to improve prognostic estimation and the choice of therapy versus IHC/FISH. |
| doi_str_mv | 10.1007/s10549-013-2572-4 |
| format | Article |
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n
= 90; including seven HER2-positive patients and eight triple-negative patients by IHC/FISH), the 5-year DMFS rate was 93 %. The pCR rate provided no prognostic information, suggesting these patients may not benefit from chemotherapy. Forty-three of 107 (40 %) HER2-positive patients were classified as Luminal-type by BluePrint and may have lower response rates to targeted therapy. Molecular subtyping identified 90 of 435 (21 %) patients as Luminal A-type (BluePrint Luminal-type/MammaPrint Low Risk) with excellent survival. The pCR rate provided no prognostic information. Molecular subtyping can improve the stratification of patients in the neoadjuvant setting: Luminal A-type (MammaPrint Low Risk) patients have a good prognosis with excellent survival and do not seem to benefit from chemotherapy. We observed marked benefit in response and DMFS to neoadjuvant treatment in patients subtyped as HER2-type and Basal-type. BluePrint with MammaPrint molecular subtyping helps to improve prognostic estimation and the choice of therapy versus IHC/FISH.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-013-2572-4</identifier><identifier>PMID: 23756626</identifier><identifier>CODEN: BCTRD6</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adjuvant treatment ; Adult ; Aged ; Analysis ; Biological and medical sciences ; Biomarkers, Tumor - analysis ; Biomarkers, Tumor - metabolism ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - metabolism ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Cancer ; Cancer patients ; Cancer research ; Cancer therapies ; Chemotherapy ; Chemotherapy, Adjuvant ; Clinical Trial ; Estrogen ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Mammary gland diseases ; Medical prognosis ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Molecular biology ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Neoadjuvant Therapy ; Oncology ; Progesterone ; Prognosis ; Receptor, ErbB-2 - analysis ; Receptor, ErbB-2 - metabolism ; Receptors, Estrogen - analysis ; Receptors, Estrogen - metabolism ; Receptors, Progesterone - analysis ; Receptors, Progesterone - metabolism ; Retrospective Studies ; Treatment Outcome ; Tumors</subject><ispartof>Breast cancer research and treatment, 2013-06, Vol.139 (3), p.759-767</ispartof><rights>Springer Science+Business Media New York 2013</rights><rights>2014 INIST-CNRS</rights><rights>COPYRIGHT 2013 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c500t-32ec02ef5b8dabae4e37ec132d4c2945a015d9d8056bfc70f1725f0b30723a2d3</citedby><cites>FETCH-LOGICAL-c500t-32ec02ef5b8dabae4e37ec132d4c2945a015d9d8056bfc70f1725f0b30723a2d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-013-2572-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-013-2572-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27584587$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23756626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Glück, Stefan</creatorcontrib><creatorcontrib>de Snoo, Femke</creatorcontrib><creatorcontrib>Peeters, Justine</creatorcontrib><creatorcontrib>Stork-Sloots, Lisette</creatorcontrib><creatorcontrib>Somlo, George</creatorcontrib><title>Molecular subtyping of early-stage breast cancer identifies a group of patients who do not benefit from neoadjuvant chemotherapy</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>The aim of this study was to analyze the correlation between the pathologic complete response (pCR) rate after neoadjuvant chemotherapy and long-term outcome (distant metastases-free survival [DMFS]) in patients with early-stage breast cancer using BluePrint and MammaPrint molecular subtyping versus clinical subtyping using immunohistochemistry/fluorescence in situ hybridization (IHC/FISH) for the determination of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (HER2). Data were analyzed from 437 patients in four neoadjuvant chemotherapy trials. BluePrint and MammaPrint outcomes were determined from 44K Agilent arrays, the I-SPY 1 data portal, or Affymetrix U133A arrays. The pCR rate differed substantially among BluePrint molecular subgroups: 6 % in Luminal A-type, 10 % in Luminal B-type, 47 % in HER2-type, and 37 % in Basal-type patients. In the Luminal A-type group (
n
= 90; including seven HER2-positive patients and eight triple-negative patients by IHC/FISH), the 5-year DMFS rate was 93 %. The pCR rate provided no prognostic information, suggesting these patients may not benefit from chemotherapy. Forty-three of 107 (40 %) HER2-positive patients were classified as Luminal-type by BluePrint and may have lower response rates to targeted therapy. Molecular subtyping identified 90 of 435 (21 %) patients as Luminal A-type (BluePrint Luminal-type/MammaPrint Low Risk) with excellent survival. The pCR rate provided no prognostic information. Molecular subtyping can improve the stratification of patients in the neoadjuvant setting: Luminal A-type (MammaPrint Low Risk) patients have a good prognosis with excellent survival and do not seem to benefit from chemotherapy. We observed marked benefit in response and DMFS to neoadjuvant treatment in patients subtyped as HER2-type and Basal-type. BluePrint with MammaPrint molecular subtyping helps to improve prognostic estimation and the choice of therapy versus IHC/FISH.</description><subject>Adjuvant treatment</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Biological and medical sciences</subject><subject>Biomarkers, Tumor - analysis</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - metabolism</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Clinical Trial</subject><subject>Estrogen</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>In Situ Hybridization, Fluorescence</subject><subject>Mammary gland diseases</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Molecular biology</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Neoadjuvant Therapy</subject><subject>Oncology</subject><subject>Progesterone</subject><subject>Prognosis</subject><subject>Receptor, ErbB-2 - analysis</subject><subject>Receptor, ErbB-2 - metabolism</subject><subject>Receptors, Estrogen - analysis</subject><subject>Receptors, Estrogen - metabolism</subject><subject>Receptors, Progesterone - analysis</subject><subject>Receptors, Progesterone - metabolism</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kk-P1SAUxRujcZ6jH8CNITEaNx0vUEq7nEz8l4xxo2tC6eU9XtpSgWrezo8u9T2dGaNhQXL53cPhcoriKYULCiBfRwqiakugvGRCsrK6V2yokLyUjMr7xQZoLcu6gfqseBTjHgBaCe3D4oxxKeqa1Zvix0c_oFkGHUhcunSY3bQl3hLUYTiUMektki6gjokYPRkMxPU4JWcdRqLJNvhlXvlZJ5frkXzfedJ7MvlEOpzQukRs8COZ0Ot-v3zTU1ba4ejTDoOeD4-LB1YPEZ-c9vPiy9s3n6_el9ef3n24urwujQBIJWdogKEVXdPrTmOFXKKhnPWVYW0lNFDRt30Dou6skWCpZMJCx0EyrlnPz4tXR905-K8LxqRGFw0Og87Olqgol0zmgTVtRp__he79Eqbs7hcFtGl4dUNt9YDKTdanoM0qqi55BQ3Iul61Lv5B5dXj6IxfB5Trdxpe3mrYoR7SLvphSc5P8S5Ij6AJPsaAVs3BjTocFAW1xkMd46FyPNQaD7V6fnZ62dKN2P_p-J2HDLw4AToaPdiQ_9zFG06KphKNzBw7cjEfTVsMt0b039t_AuSz0Uo</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>Glück, Stefan</creator><creator>de Snoo, Femke</creator><creator>Peeters, Justine</creator><creator>Stork-Sloots, Lisette</creator><creator>Somlo, George</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20130601</creationdate><title>Molecular subtyping of early-stage breast cancer identifies a group of patients who do not benefit from neoadjuvant chemotherapy</title><author>Glück, Stefan ; de Snoo, Femke ; Peeters, Justine ; Stork-Sloots, Lisette ; Somlo, George</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c500t-32ec02ef5b8dabae4e37ec132d4c2945a015d9d8056bfc70f1725f0b30723a2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adjuvant treatment</topic><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Biological and medical sciences</topic><topic>Biomarkers, Tumor - analysis</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - metabolism</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Clinical Trial</topic><topic>Estrogen</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>In Situ Hybridization, Fluorescence</topic><topic>Mammary gland diseases</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Molecular biology</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Neoadjuvant Therapy</topic><topic>Oncology</topic><topic>Progesterone</topic><topic>Prognosis</topic><topic>Receptor, ErbB-2 - analysis</topic><topic>Receptor, ErbB-2 - metabolism</topic><topic>Receptors, Estrogen - analysis</topic><topic>Receptors, Estrogen - metabolism</topic><topic>Receptors, Progesterone - analysis</topic><topic>Receptors, Progesterone - metabolism</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Glück, Stefan</creatorcontrib><creatorcontrib>de Snoo, Femke</creatorcontrib><creatorcontrib>Peeters, Justine</creatorcontrib><creatorcontrib>Stork-Sloots, Lisette</creatorcontrib><creatorcontrib>Somlo, George</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Glück, Stefan</au><au>de Snoo, Femke</au><au>Peeters, Justine</au><au>Stork-Sloots, Lisette</au><au>Somlo, George</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Molecular subtyping of early-stage breast cancer identifies a group of patients who do not benefit from neoadjuvant chemotherapy</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>139</volume><issue>3</issue><spage>759</spage><epage>767</epage><pages>759-767</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><coden>BCTRD6</coden><abstract>The aim of this study was to analyze the correlation between the pathologic complete response (pCR) rate after neoadjuvant chemotherapy and long-term outcome (distant metastases-free survival [DMFS]) in patients with early-stage breast cancer using BluePrint and MammaPrint molecular subtyping versus clinical subtyping using immunohistochemistry/fluorescence in situ hybridization (IHC/FISH) for the determination of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (HER2). Data were analyzed from 437 patients in four neoadjuvant chemotherapy trials. BluePrint and MammaPrint outcomes were determined from 44K Agilent arrays, the I-SPY 1 data portal, or Affymetrix U133A arrays. The pCR rate differed substantially among BluePrint molecular subgroups: 6 % in Luminal A-type, 10 % in Luminal B-type, 47 % in HER2-type, and 37 % in Basal-type patients. In the Luminal A-type group (
n
= 90; including seven HER2-positive patients and eight triple-negative patients by IHC/FISH), the 5-year DMFS rate was 93 %. The pCR rate provided no prognostic information, suggesting these patients may not benefit from chemotherapy. Forty-three of 107 (40 %) HER2-positive patients were classified as Luminal-type by BluePrint and may have lower response rates to targeted therapy. Molecular subtyping identified 90 of 435 (21 %) patients as Luminal A-type (BluePrint Luminal-type/MammaPrint Low Risk) with excellent survival. The pCR rate provided no prognostic information. Molecular subtyping can improve the stratification of patients in the neoadjuvant setting: Luminal A-type (MammaPrint Low Risk) patients have a good prognosis with excellent survival and do not seem to benefit from chemotherapy. We observed marked benefit in response and DMFS to neoadjuvant treatment in patients subtyped as HER2-type and Basal-type. BluePrint with MammaPrint molecular subtyping helps to improve prognostic estimation and the choice of therapy versus IHC/FISH.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23756626</pmid><doi>10.1007/s10549-013-2572-4</doi><tpages>9</tpages></addata></record> |
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| ispartof | Breast cancer research and treatment, 2013-06, Vol.139 (3), p.759-767 |
| issn | 0167-6806 1573-7217 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adjuvant treatment Adult Aged Analysis Biological and medical sciences Biomarkers, Tumor - analysis Biomarkers, Tumor - metabolism Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - metabolism Breast Neoplasms - mortality Breast Neoplasms - pathology Cancer Cancer patients Cancer research Cancer therapies Chemotherapy Chemotherapy, Adjuvant Clinical Trial Estrogen Female Gynecology. Andrology. Obstetrics Humans Immunohistochemistry In Situ Hybridization, Fluorescence Mammary gland diseases Medical prognosis Medical sciences Medicine Medicine & Public Health Middle Aged Molecular biology Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Neoadjuvant Therapy Oncology Progesterone Prognosis Receptor, ErbB-2 - analysis Receptor, ErbB-2 - metabolism Receptors, Estrogen - analysis Receptors, Estrogen - metabolism Receptors, Progesterone - analysis Receptors, Progesterone - metabolism Retrospective Studies Treatment Outcome Tumors |
| title | Molecular subtyping of early-stage breast cancer identifies a group of patients who do not benefit from neoadjuvant chemotherapy |
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