Breast-cancer-specific mortality in patients treated based on the 21-gene assay

A SEER population-based study

Valentina I. Petkov, Dave P. Miller, Nadia Howlader, Nathan Gliner, Will Howe, Nicola Schussler, Kathleen Cronin, Frederick L. Baehner, Rosemary D Cress, Dennis Deapen, Sally L. Glaser, Brenda Y. Hernandez, Charles F. Lynch, Lloyd Mueller, Ann G. Schwartz, Stephen M. Schwartz, Antoinette Stroup, Carol Sweeney, Thomas C. Tucker, Kevin C. Ward & 4 others Charles Wiggins, Xiao Cheng Wu, Lynne Penberthy, Steven Shak

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

The 21-gene Recurrence Score assay is validated to predict recurrence risk and chemotherapy benefit in hormone-receptor-positive (HR+) invasive breast cancer. To determine prospective breast-cancer-specific mortality (BCSM) outcomes by baseline Recurrence Score results and clinical covariates, the National Cancer Institute collaborated with Genomic Health and 14 population-based registries in the the Surveillance, Epidemiology, and End Results (SEER) Program to electronically supplement cancer surveillance data with Recurrence Score results. The prespecified primary analysis cohort was 40–84 years of age, and had node-negative, HR+, HER2-negative, nonmetastatic disease diagnosed between January 2004 and December 2011 in the entire SEER population, and Recurrence Score results (N = 38,568). Unadjusted 5-year BCSM were 0.4% (n = 21,023; 95% confidence interval (CI), 0.3–0.6%), 1.4% (n = 14,494; 95% CI, 1.1–1.7%), and 4.4% (n = 3,051; 95% CI, 3.4–5.6%) for Recurrence Score <18, 18–30, and ≥ 31 groups, respectively (P<0.001). In multivariable analysis adjusted for age, tumor size, grade, and race, the Recurrence Score result predicted BCSM (P<0.001). Among patients with node-positive disease (micrometastases and up to three positive nodes; N = 4,691), 5-year BCSM (unadjusted) was 1.0% (n = 2,694; 95% CI, 0.5–2.0%), 2.3% (n = 1,669; 95% CI, 1.3–4.1%), and 14.3% (n = 328; 95% CI, 8.4– 23.8%) for Recurrence Score <18, 18–30, ≥ 31 groups, respectively (P<0.001). Five-year BCSM by Recurrence Score group are reported for important patient subgroups, including age, race, tumor size, grade, and socioeconomic status. This SEER study represents the largest report of prospective BCSM outcomes based on Recurrence Score results for patients with HR+, HER2-negative, node-negative, or node-positive breast cancer, including subgroups often under-represented in clinical trials.

Original languageEnglish (US)
Article number16017
Journalnpj Breast Cancer
Volume2
Issue number1
DOIs
StatePublished - Dec 14 2016
Externally publishedYes

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Epidemiology
Breast Neoplasms
Recurrence
Mortality
Population
Genes
Confidence Intervals
SEER Program
Neoplasms
Neoplasm Micrometastasis
National Cancer Institute (U.S.)
Social Class
Registries
Cohort Studies
Clinical Trials
Hormones
Drug Therapy
Health

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

Cite this

Petkov, V. I., Miller, D. P., Howlader, N., Gliner, N., Howe, W., Schussler, N., ... Shak, S. (2016). Breast-cancer-specific mortality in patients treated based on the 21-gene assay: A SEER population-based study. npj Breast Cancer, 2(1), [16017]. https://doi.org/10.1038/npjbcancer.2016.17

Breast-cancer-specific mortality in patients treated based on the 21-gene assay : A SEER population-based study. / Petkov, Valentina I.; Miller, Dave P.; Howlader, Nadia; Gliner, Nathan; Howe, Will; Schussler, Nicola; Cronin, Kathleen; Baehner, Frederick L.; Cress, Rosemary D; Deapen, Dennis; Glaser, Sally L.; Hernandez, Brenda Y.; Lynch, Charles F.; Mueller, Lloyd; Schwartz, Ann G.; Schwartz, Stephen M.; Stroup, Antoinette; Sweeney, Carol; Tucker, Thomas C.; Ward, Kevin C.; Wiggins, Charles; Wu, Xiao Cheng; Penberthy, Lynne; Shak, Steven.

In: npj Breast Cancer, Vol. 2, No. 1, 16017, 14.12.2016.

Research output: Contribution to journalArticle

Petkov, VI, Miller, DP, Howlader, N, Gliner, N, Howe, W, Schussler, N, Cronin, K, Baehner, FL, Cress, RD, Deapen, D, Glaser, SL, Hernandez, BY, Lynch, CF, Mueller, L, Schwartz, AG, Schwartz, SM, Stroup, A, Sweeney, C, Tucker, TC, Ward, KC, Wiggins, C, Wu, XC, Penberthy, L & Shak, S 2016, 'Breast-cancer-specific mortality in patients treated based on the 21-gene assay: A SEER population-based study', npj Breast Cancer, vol. 2, no. 1, 16017. https://doi.org/10.1038/npjbcancer.2016.17
Petkov, Valentina I. ; Miller, Dave P. ; Howlader, Nadia ; Gliner, Nathan ; Howe, Will ; Schussler, Nicola ; Cronin, Kathleen ; Baehner, Frederick L. ; Cress, Rosemary D ; Deapen, Dennis ; Glaser, Sally L. ; Hernandez, Brenda Y. ; Lynch, Charles F. ; Mueller, Lloyd ; Schwartz, Ann G. ; Schwartz, Stephen M. ; Stroup, Antoinette ; Sweeney, Carol ; Tucker, Thomas C. ; Ward, Kevin C. ; Wiggins, Charles ; Wu, Xiao Cheng ; Penberthy, Lynne ; Shak, Steven. / Breast-cancer-specific mortality in patients treated based on the 21-gene assay : A SEER population-based study. In: npj Breast Cancer. 2016 ; Vol. 2, No. 1.
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abstract = "The 21-gene Recurrence Score assay is validated to predict recurrence risk and chemotherapy benefit in hormone-receptor-positive (HR+) invasive breast cancer. To determine prospective breast-cancer-specific mortality (BCSM) outcomes by baseline Recurrence Score results and clinical covariates, the National Cancer Institute collaborated with Genomic Health and 14 population-based registries in the the Surveillance, Epidemiology, and End Results (SEER) Program to electronically supplement cancer surveillance data with Recurrence Score results. The prespecified primary analysis cohort was 40–84 years of age, and had node-negative, HR+, HER2-negative, nonmetastatic disease diagnosed between January 2004 and December 2011 in the entire SEER population, and Recurrence Score results (N = 38,568). Unadjusted 5-year BCSM were 0.4{\%} (n = 21,023; 95{\%} confidence interval (CI), 0.3–0.6{\%}), 1.4{\%} (n = 14,494; 95{\%} CI, 1.1–1.7{\%}), and 4.4{\%} (n = 3,051; 95{\%} CI, 3.4–5.6{\%}) for Recurrence Score <18, 18–30, and ≥ 31 groups, respectively (P<0.001). In multivariable analysis adjusted for age, tumor size, grade, and race, the Recurrence Score result predicted BCSM (P<0.001). Among patients with node-positive disease (micrometastases and up to three positive nodes; N = 4,691), 5-year BCSM (unadjusted) was 1.0{\%} (n = 2,694; 95{\%} CI, 0.5–2.0{\%}), 2.3{\%} (n = 1,669; 95{\%} CI, 1.3–4.1{\%}), and 14.3{\%} (n = 328; 95{\%} CI, 8.4– 23.8{\%}) for Recurrence Score <18, 18–30, ≥ 31 groups, respectively (P<0.001). Five-year BCSM by Recurrence Score group are reported for important patient subgroups, including age, race, tumor size, grade, and socioeconomic status. This SEER study represents the largest report of prospective BCSM outcomes based on Recurrence Score results for patients with HR+, HER2-negative, node-negative, or node-positive breast cancer, including subgroups often under-represented in clinical trials.",
author = "Petkov, {Valentina I.} and Miller, {Dave P.} and Nadia Howlader and Nathan Gliner and Will Howe and Nicola Schussler and Kathleen Cronin and Baehner, {Frederick L.} and Cress, {Rosemary D} and Dennis Deapen and Glaser, {Sally L.} and Hernandez, {Brenda Y.} and Lynch, {Charles F.} and Lloyd Mueller and Schwartz, {Ann G.} and Schwartz, {Stephen M.} and Antoinette Stroup and Carol Sweeney and Tucker, {Thomas C.} and Ward, {Kevin C.} and Charles Wiggins and Wu, {Xiao Cheng} and Lynne Penberthy and Steven Shak",
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T2 - A SEER population-based study

AU - Petkov, Valentina I.

AU - Miller, Dave P.

AU - Howlader, Nadia

AU - Gliner, Nathan

AU - Howe, Will

AU - Schussler, Nicola

AU - Cronin, Kathleen

AU - Baehner, Frederick L.

AU - Cress, Rosemary D

AU - Deapen, Dennis

AU - Glaser, Sally L.

AU - Hernandez, Brenda Y.

AU - Lynch, Charles F.

AU - Mueller, Lloyd

AU - Schwartz, Ann G.

AU - Schwartz, Stephen M.

AU - Stroup, Antoinette

AU - Sweeney, Carol

AU - Tucker, Thomas C.

AU - Ward, Kevin C.

AU - Wiggins, Charles

AU - Wu, Xiao Cheng

AU - Penberthy, Lynne

AU - Shak, Steven

PY - 2016/12/14

Y1 - 2016/12/14

N2 - The 21-gene Recurrence Score assay is validated to predict recurrence risk and chemotherapy benefit in hormone-receptor-positive (HR+) invasive breast cancer. To determine prospective breast-cancer-specific mortality (BCSM) outcomes by baseline Recurrence Score results and clinical covariates, the National Cancer Institute collaborated with Genomic Health and 14 population-based registries in the the Surveillance, Epidemiology, and End Results (SEER) Program to electronically supplement cancer surveillance data with Recurrence Score results. The prespecified primary analysis cohort was 40–84 years of age, and had node-negative, HR+, HER2-negative, nonmetastatic disease diagnosed between January 2004 and December 2011 in the entire SEER population, and Recurrence Score results (N = 38,568). Unadjusted 5-year BCSM were 0.4% (n = 21,023; 95% confidence interval (CI), 0.3–0.6%), 1.4% (n = 14,494; 95% CI, 1.1–1.7%), and 4.4% (n = 3,051; 95% CI, 3.4–5.6%) for Recurrence Score <18, 18–30, and ≥ 31 groups, respectively (P<0.001). In multivariable analysis adjusted for age, tumor size, grade, and race, the Recurrence Score result predicted BCSM (P<0.001). Among patients with node-positive disease (micrometastases and up to three positive nodes; N = 4,691), 5-year BCSM (unadjusted) was 1.0% (n = 2,694; 95% CI, 0.5–2.0%), 2.3% (n = 1,669; 95% CI, 1.3–4.1%), and 14.3% (n = 328; 95% CI, 8.4– 23.8%) for Recurrence Score <18, 18–30, ≥ 31 groups, respectively (P<0.001). Five-year BCSM by Recurrence Score group are reported for important patient subgroups, including age, race, tumor size, grade, and socioeconomic status. This SEER study represents the largest report of prospective BCSM outcomes based on Recurrence Score results for patients with HR+, HER2-negative, node-negative, or node-positive breast cancer, including subgroups often under-represented in clinical trials.

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