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. 2023 Aug:189:112930.
doi: 10.1016/j.ejca.2023.05.018. Epub 2023 Jun 1.

Estimating mortality in women with triple-negative breast cancer: The 'ESTIMATE triple-negative' tool

José P Leone  1 , Noah Graham  2 , Julieta Leone  3 , Sara M Tolaney  4 , Bernardo A Leone  3 , Rachel A Freedman  4 , Michael J Hassett  4 , Carlos T Vallejo  3 , Eric P Winer  4 , Nancy U Lin  4 , Nabihah Tayob  5
Affiliations

Estimating mortality in women with triple-negative breast cancer: The 'ESTIMATE triple-negative' tool

José P Leone et al. Eur J Cancer. 2023 Aug.

Abstract

Purpose: Triple-negative breast cancer (TNBC) is associated with a high risk of breast cancer-specific mortality (BCSM). Estimating the risk of BCSM and non-BCSM in TNBC would aid clinical decision-making. We developed the tool 'ESTIMATE-TN', to assess BCSM, non-BCSM, and all-cause mortality in non-metastatic TNBC.

Methods: Using Surveillance, Epidemiology, and End Results (SEER), we created an interactive tool that provides a nonparametric estimate of the cumulative risk of BCSM and non-BCSM between years 0 and 7 from diagnosis, accounting for baseline clinical and pathologic variables, using Gray's subdistribution method.

Results: We included 37,293 women with TNBC diagnosed during 2010-2017. Most patients were White (71.9%) and aged 50-69 years (51.3%). Most tumour characteristics were high-grade (78.6%), T2 (42.4%), and N0 (69.5%). ESTIMATE-TN allows to input patient and tumour characteristics, and the preferred timeframe. For example, patients aged 50-59 years with a new diagnosis of T2, N1, high-grade TNBC have a risk of BCSM at 7 years of 30.8% (95% confidence interval [CI]: 26.3-35.4%) and a risk of non-BCSM over the same period of 2.8% (95% CI: 1.3-4.3%). After 3 years from initial diagnosis, the residual cumulative risks of BCSM and non-BCSM at 7 years are 17.4% (95% CI: 12.6-22.2%) and 1.1% (95% CI: 0-2.5%), respectively.

Conclusions: ESTIMATE-TN is an interactive tool for TNBC that can be used to integrate population-based risks of BCSM and non-BCSM based on patient and tumour characteristics, facilitating our understanding of competing risks of death, which can aid clinical decision-making.

Keywords: Calculator; Competing risks; Death; ER negative; Survival.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JPL received research funding from Kazia Therapeutics and consulting honoraria from Minerva Biotechnologies. RAF has institutional research funding from Puma Biotechnology. SMT receives institutional research funding from Genentech/Roche, Merck, Exelixis, Pfizer, Lilly, Novartis, Bristol Myers Squibb, Eisai, AstraZeneca, NanoString Technologies, Cyclacel, Nektar, Gilead, Sanofi, and Seattle Genetics; and has served as an advisor/consultant to Novartis, Pfizer, Merck, Eli Lilly, AstraZeneca, Genentech/Roche, Eisai, Sanofi, Bristol Myers Squibb, Seattle Genetics, Odonate Therapeutics, CytomX Therapeutics, Daiichi Sankyo, Athenex, Gilead, Mersana, Certara, Ellipses Pharma, 4D Pharma, OncoSec Medical Inc., BeyondSpring Pharmaceuticals, OncXerna, Zymeworks, Zentalis, Blueprint Medicines, Reveal Genomics, ARC Therapeutics, Infinity Therapeutics, Chugai Pharmaceuticals, Myovant, Zetagen, Umoja Biopharma, Menarini/Stemline, Aadi Bio, and Bayer. EPW reports institutional research funding from Genentech/Roche; serving as a consultant for Athenex, Carrick Therapeutics, G1 Therapeutics, Genentech/Roche, Genomic Health, Gilead, GlaxoSmithKline, GSK, Jounce, Lilly, St. Lucia, Syros, and Zymeworks; a non-paid scientific advisory board membership at Leap Therapeutics; and serving as President-Elect of the American Society of Clinical Oncology (ASCO). NUL reports institutional research funding from Genentech, Merck, Pfizer, Seattle Genetics, AstraZeneca, and Zion Pharmaceuticals; consultant/advisory board work for Pfizer, Puma, Seattle Genetics, Daiichi Sankyo, AstraZeneca, Prelude Therapeutics, Denali Therapeutics, Olema Pharmaceuticals, Aleta BioPharma, and Affinia Therapeutics; and royalties from UpToDate. All other authors report no conflicts.

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