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Differences in 21-Gene and PAM50 Recurrence Scores in Younger and Black Women With Breast Cancer.
Van Alsten, Sarah C; Vohra, Sanah N; Ivory, Joannie M; Hamilton, Alina M; Gao, Xiaohua; Kirk, Erin L; Butler, Eboneé N; Earp, H Shelton; Reeder-Hayes, Katherine E; Hoadley, Katherine A; Carey, Lisa A; Troester, Melissa A.
Afiliación
  • Van Alsten SC; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Vohra SN; Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Ivory JM; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Hamilton AM; Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Gao X; Division of Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Kirk EL; Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Butler EN; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Earp HS; Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Reeder-Hayes KE; Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Hoadley KA; Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Carey LA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Troester MA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
JCO Precis Oncol ; 8: e2400137, 2024 Jul.
Article en En | MEDLINE | ID: mdl-39013134
ABSTRACT

PURPOSE:

Genomic tests, such as the Oncotype Dx 21-gene and Prosigna risk of recurrence (ROR-P) assay, are commonly used for breast cancer prognostication. Emerging data suggest variability between assays, but this has not been compared in diverse populations. MATERIALS AND

METHODS:

RNA sequencing was performed on 647 previously untreated stage I-III estrogen receptor-positive/human epidermal growth factor receptor 2-negative tumors in the Carolina Breast Cancer Study, which oversampled Black and younger women (age <50 years at diagnosis), using research versions of two common RNA-based prognostic assays ROR-PR and the 21-gene recurrence score (RSR). Relative frequency differences and 95% CIs were estimated for associations with race and age, and hazards of 5-year local or distant recurrence were modeled with Cox regression. Proliferation and estrogen module scores from each assay, representing broad activity of genes in those pathways, were examined to guide interpretation of differences between tests.

RESULTS:

Among both younger and older individuals, Black women had higher frequency of intermediate and high ROR-PR scores than non-Black women. Race was not significantly associated with RSR in either age group. High (hazard ratio [HR], 4.67 [95% CI, 1.73 to 12.70]) and intermediate (HR, 2.12 [95% CI, 0.98 to 4.62]) ROR-PR scores were associated with greater risk of recurrence, but RSR did not predict recurrence. RSR emphasized estrogen over proliferation modules, whereas ROR-PR emphasized proliferation. Higher proliferation scores were associated with younger age and Black race in both assays. Modifications to the RSR algorithm that increased emphasis on proliferation improved prognostication in this diverse population.

CONCLUSION:

ROR-PR and the 21-gene RSR differentially emphasize estrogen-related and proliferative biology. The emphasis of 21-gene RS on estrogen-related biology and lower endocrine therapy initiation among Black women may contribute to poorer prognostic ability in heterogeneously treated populations.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Recurrencia Local de Neoplasia Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: JCO Precis Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Recurrencia Local de Neoplasia Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: JCO Precis Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos