Clinical Treatment Score Post-5 Years (CTS5) and Late Recurrence Risk in Hormone Receptor-Positive, HER2-Positive Breast Cancer.

IF 14.8 2区医学 Q1 ONCOLOGY

Journal of the National Comprehensive Cancer Network Pub Date : 2024-08-26 DOI:10.6004/jnccn.2024.7015

Saranya Chumsri, Tanmayi Pai, Yaohua Ma, Zhuo Li, Angelica Gil, Alvaro Moreno-Aspitia, Gerardo Colon-Otero, Katherine L Pogue-Geile, Priya Rasgoti, Soonmyung Paik, Edith A Perez, E Aubrey Thompson

{"title":"Clinical Treatment Score Post-5 Years (CTS5) and Late Recurrence Risk in Hormone Receptor-Positive, HER2-Positive Breast Cancer.","authors":"Saranya Chumsri, Tanmayi Pai, Yaohua Ma, Zhuo Li, Angelica Gil, Alvaro Moreno-Aspitia, Gerardo Colon-Otero, Katherine L Pogue-Geile, Priya Rasgoti, Soonmyung Paik, Edith A Perez, E Aubrey Thompson","doi":"10.6004/jnccn.2024.7015","DOIUrl":null,"url":null,"abstract":"Background: The Clinical Treatment Score post-5 years (CTS5) is a risk stratification tool used to determine the risk of late recurrence in hormone receptor-positive (HR+), HER2-negative breast cancer (BC). Limited data exist on its use in HR+, HER2-positive (HER2+) BC.Patients and methods: CTS5 was evaluated in HR+, HER2+ BC in the North Central Cancer Treatment Group (NCCTG) N9831 (Alliance) and NSABP B-31 (NRG) trials.Results: A total of 1,862 patients with HR+, HER2+ BC without recurrence 5 years after enrollment were included. Overall, the CTS5 score was significantly associated with recurrence-free survival (RFS), with a hazard ratio (HR) of 1.35 (95% CI, 1.12-1.63; P=.002), but did not reach statistical significance in patients who received trastuzumab (n=829; HR, 1.29; 95% CI, 0.98-1.71; P=.07). CTS5 risk category was not significantly associated with RFS. In patients who received trastuzumab, other variables used in CTS5, including patient age and tumor size, were not significantly associated with RFS. N3 was significantly associated with worse outcomes (HR, 1.86; 95% CI, 1.09-3.17; P=.02) compared with N0-N1. Paradoxically, higher tumor grade was associated with better outcomes after 5 years in the multivariate analysis (HR, 0.71; 95% CI, 0.50-1.00; P=.05). The incidence of recurrences or deaths between years 5 to 10 was 10.6% in the CTS5 low-risk category, 5.6% in the intermediate-risk category, and 9.8% in the high-risk category.Conclusions: The CTS5 model does not accurately predict the risk of late recurrence in HR+, HER2+ BC treated with adjuvant trastuzumab in the N9831 and B-31 trials. This study underlines the need to develop a new prognostic model to better delineate the risk of late recurrence in patients with HR+, HER2+ BC receiving adjuvant trastuzumab.Clinicaltrials: gov identifiers: NCT00005970 (NCCTG N9831) and NCT00004067 (NRG/NSABP B-31).","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"463-468"},"PeriodicalIF":14.8000,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473094/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the National Comprehensive Cancer Network","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.6004/jnccn.2024.7015","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The Clinical Treatment Score post-5 years (CTS5) is a risk stratification tool used to determine the risk of late recurrence in hormone receptor-positive (HR+), HER2-negative breast cancer (BC). Limited data exist on its use in HR+, HER2-positive (HER2+) BC.

Patients and methods: CTS5 was evaluated in HR+, HER2+ BC in the North Central Cancer Treatment Group (NCCTG) N9831 (Alliance) and NSABP B-31 (NRG) trials.

Results: A total of 1,862 patients with HR+, HER2+ BC without recurrence 5 years after enrollment were included. Overall, the CTS5 score was significantly associated with recurrence-free survival (RFS), with a hazard ratio (HR) of 1.35 (95% CI, 1.12-1.63; P=.002), but did not reach statistical significance in patients who received trastuzumab (n=829; HR, 1.29; 95% CI, 0.98-1.71; P=.07). CTS5 risk category was not significantly associated with RFS. In patients who received trastuzumab, other variables used in CTS5, including patient age and tumor size, were not significantly associated with RFS. N3 was significantly associated with worse outcomes (HR, 1.86; 95% CI, 1.09-3.17; P=.02) compared with N0-N1. Paradoxically, higher tumor grade was associated with better outcomes after 5 years in the multivariate analysis (HR, 0.71; 95% CI, 0.50-1.00; P=.05). The incidence of recurrences or deaths between years 5 to 10 was 10.6% in the CTS5 low-risk category, 5.6% in the intermediate-risk category, and 9.8% in the high-risk category.

Conclusions: The CTS5 model does not accurately predict the risk of late recurrence in HR+, HER2+ BC treated with adjuvant trastuzumab in the N9831 and B-31 trials. This study underlines the need to develop a new prognostic model to better delineate the risk of late recurrence in patients with HR+, HER2+ BC receiving adjuvant trastuzumab.

Clinicaltrials: gov identifiers: NCT00005970 (NCCTG N9831) and NCT00004067 (NRG/NSABP B-31).

查看原文本刊更多论文

激素受体阳性、HER2 阳性乳腺癌患者 5 年后临床治疗评分 (CTS5) 与晚期复发风险。

背景：5年后临床治疗评分（CTS5）是一种风险分层工具，用于确定激素受体阳性（HR+）、HER2阴性乳腺癌（BC）的晚期复发风险。关于它在激素受体阳性（HR+）、HER2阳性（HER2+）乳腺癌中的应用数据有限：中北部癌症治疗组（NCCTG）N9831（Alliance）和NSABP B-31（NRG）试验对CTS5在HR+、HER2+ BC中的应用进行了评估：共纳入了1862名HR+、HER2+ BC患者，这些患者在入组5年后未再复发。总体而言，CTS5评分与无复发生存期（RFS）显著相关，危险比（HR）为1.35（95% CI，1.12-1.63；P=.002），但在接受曲妥珠单抗治疗的患者中未达到统计学意义（n=829；HR，1.29；95% CI，0.98-1.71；P=.07）。CTS5风险类别与RFS无明显相关性。在接受曲妥珠单抗治疗的患者中，CTS5中使用的其他变量（包括患者年龄和肿瘤大小）与RFS无显著相关性。与N0-N1相比，N3与较差的预后明显相关（HR，1.86；95% CI，1.09-3.17；P=.02）。矛盾的是，在多变量分析中，肿瘤分级越高，5年后的预后越好（HR，0.71；95% CI，0.50-1.00；P=.05）。在CTS5低风险类别中，5至10年的复发或死亡发生率为10.6%，中风险类别为5.6%，高风险类别为9.8%：结论：CTS5模型不能准确预测N9831和B-31试验中接受曲妥珠单抗辅助治疗的HR+、HER2+ BC患者的晚期复发风险。这项研究强调了开发新预后模型的必要性，以便更好地界定接受曲妥珠单抗辅助治疗的HR+、HER2+ BC患者的晚期复发风险：NCT00005970（NCCTG N9831）和NCT00004067（NRG/NSABP B-31）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of the National Comprehensive Cancer Network ONCOLOGY-

CiteScore

20.20

自引率

0.00%

发文量

388

审稿时长

4-8 weeks

期刊介绍： JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.