Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 31:10:1315.
doi: 10.3389/fonc.2020.01315. eCollection 2020.

Primary 21-Gene Recurrence Score and Disease Outcome in Loco-Regional and Distant Recurrent Breast Cancer Patients

Yujie Lu  1 , Yiwei Tong  1 , Jiahui Huang  1 , Lin Lin  2 , Jiayi Wu  1 , Xiaochun Fei  3 , Ou Huang  1 , Jianrong He  1 , Li Zhu  1 , Weiguo Chen  1 , Yafen Li  1 , Xiaosong Chen  1 , Kunwei Shen  1
Affiliations

Primary 21-Gene Recurrence Score and Disease Outcome in Loco-Regional and Distant Recurrent Breast Cancer Patients

Yujie Lu et al. Front Oncol. .

Abstract

Background: The 21-gene recurrence score (RS) assay has been proven prognostic and predictive for hormone receptor-positive/HER2-negative, node-negative early breast cancer patients. However, whether primary 21-gene RS can predict prognosis in recurrent breast cancer patients remained unknown. Patients and Methods: Consecutive breast cancer patients operated in Comprehensive Breast Health Center, Shanghai Ruijin Hospital between January 2009 and December 2018 were retrospectively analyzed. Patients with available 21-gene RS result for the primary tumor and reporting disease recurrence during follow-up were included. Association of 21-gene RS and overall survival (OS), post-recurrence overall survival (PR-OS), post-recurrence progression-free survival (PR-PFS), and first-line systemic treatment after recurrence were compared among different groups. Results: A total of 74 recurrent patients were included, with 10, 27, 37 patients in the RS <18, 18-30, and ≥ 31 groups, respectively. Recurrent patients with RS ≥ 31 were more likely to receive chemotherapy as their first-line treatment compared to those with RS <31 (P = 0.025). Compared to those with RS <31, patients with RS ≥ 31 had significantly worse OS (P = 0.025), worse PR-OS (P = 0.026), and a trend of inferior PR-PFS (P = 0.106). Multivariate analysis demonstrated that primary ER expression level (OS: P = 0.009; PR-OS: P = 0.017) and histological grade (OS: P = 0.003; PR-OS: P = 0.009), but not primary 21-gene RS (OS: P = 0.706; PR-OS: P = 0.120), were independently associated with worse OS and PR-OS. Conclusions: High primary 21-gene RS tended to be associated with worse disease outcome in loco-regional and distant recurrent breast cancer patients, which could influence the first-line systemic treatment after relapse, warranting further clinical evaluation.

Keywords: 21-gene RS; breast cancer; first-line treatment; prognosis; recurrence.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of included patients. CBHC, Comprehensive Breast Health Center; RS, recurrence score; ALN, axillary lymph node; IHC, immunohistochemical.
Figure 2
Figure 2
Distribution of first line systemic treatment recommendation after disease recurrence. RS, recurrence score; CT, chemotherapy; ET, endocrine therapy.
Figure 3
Figure 3
Association between 21-gene RS and survival in recurrent breast cancer patients. Overall survival (A), Post recurrence survival (B), and Post recurrence progression free survival (C) in the whole cohort; Overall survival (D), Post recurrence survival (E), and Post recurrence progression free survival (F) in patients with distant metastasis patients. RS, recurrence score.
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. (2018) 68:394–424. 10.3322/caac.21492 - DOI - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics 2020. CA Cancer J Clin. (2020) 70:7–30. 10.3322/caac.21590 - DOI - PubMed
    1. Early Breast Cancer Trialists' Collaborative Group (EBCTCG) . Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. (2005) 365:1687–717. 10.1016/S0140-6736(05)66544-0 - DOI - PubMed
    1. Perez EA, Romond EH, Suman VJ, Jeong JH, Davidson NE, Geyer CE, et al. . Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable human epidermal growth factor receptor 2-positive breast cancer: joint analysis of data from NCCTG N9831 and NSABP B-31. J Clin Oncol. (2011) 29:3366–73. 10.1200/JCO.2011.35.0868 - DOI - PMC - PubMed
    1. Tevaarwerk AJ, Gray RJ, Schneider BP, Smith ML, Wagner LI, Fetting JH, et al. . Survival in patients with metastatic recurrent breast cancer after adjuvant chemotherapy: little evidence of improvement over the past 30 years. Cancer. (2013) 119:1140–8. 10.1002/cncr.27819 - DOI - PMC - PubMed