采用新辅助类固醇疗法治疗早期三阴性乳腺癌的 TNBC-DX 基因组检测。

IF 56.7 1区 医学 Q1 ONCOLOGY
M Martín, S R Stecklein, O Gluz, G Villacampa, M Monte-Millán, U Nitz, S Cobo, M Christgen, F Brasó-Maristany, E L Álvarez, I Echavarría, B Conte, S Kuemmel, C Bueno-Muiño, Y Jerez, R Kates, M Cebollero, C Kolberg-Liedtke, O Bueno, J Á García-Saenz, F Moreno, E-M Grischke, H Forstbauer, M Braun, M Warm, J Hackmann, C Uleer, B Aktas, C Schumacher, R Wuerstleins, M Graeser, C Zu Eulenburg, H H Kreipe, H Gómez, T Massarrah, B Herrero, L Paré, U Bohn, S López-Tarruella, A Vivancos, E Sanfeliu, J S Parker, C M Perou, P Villagrasa, A Prat, P Sharma, N Harbeck
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引用次数: 0

摘要

背景:鉴定生物标志物以优化早期三阴性乳腺癌(TNBC)的治疗策略至关重要。本研究介绍了 TNBC-DX 的开发和验证情况,这是一种新型检测方法,旨在预测早期 TNBC 的短期和长期预后:方法:1,259 名早期 TNBC 患者的信息(SCAN-B、CALGB-40603 和 BrighTNess)被用于建立 TNBC-DX 评分。3项研究对TNBC-DX进行了独立验证:i) WSG-ADAPT-TN;ii) MMJ-CAR-2014-01;iii) NeoPACT,包括527名接受新辅助化疗的I-III期TNBC患者。在WSG-ADAPT-TN中,患者被随机分配接受纳布-紫杉醇加吉西他滨或卡铂治疗。在 MMJ-CAR-2014-01 中,患者接受卡铂加多西他赛治疗。在NeoPACT中,患者接受卡铂加多西他赛和pembrolizumab治疗。本研究的目的是评估 TNBC-DX 与验证队列中疗效结果(pCR、无远处疾病生存期 [DDFS] 或无事件生存期 [EFS] 以及总生存期 [OS])之间的关联:TNBC-DX检验结合了10基因核心免疫基因模块、4基因肿瘤细胞增殖特征、肿瘤大小和结节分期。在没有使用彭博利珠单抗的两个独立验证队列中,在调整临床病理变量和治疗方案后,TNBC-DX pCR评分与pCR显著相关(每增加10个单位的几率比=1.34,95% CI 1.20-1.52,p结论:TNBC-DX可预测pCR:TNBC-DX可预测I-III期TNBC患者接受新辅助类固醇-卡铂治疗后的pCR,并有助于预测患者在未接受新辅助蒽环类/环磷酰胺治疗的情况下的长期生存率,且不受使用彭博利珠单抗的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
TNBC-DX genomic test in early-stage triple-negative breast cancer treated with neoadjuvant taxane-based therapy.

Background: Identification of biomarkers to optimize treatment strategies for early-stage triple-negative breast cancer (TNBC) is crucial. This study presents the development and validation of TNBC-DX, a novel test aimed at predicting both short- and long-term outcomes in early-stage TNBC. The objective of this study was to evaluate the association between TNBC-DX and efficacy outcomes [pathologic complete response (pCR), distant disease-free survival (DDFS) or event-free survival (EFS), and overall survival (OS)] in the validation cohorts.

Methods: Information from 1259 patients with early-stage TNBC (SCAN-B, CALGB-40603, and BrighTNess) was used to establish the TNBC-DX scores. Independent validation of TNBC-DX was carried out in three studies: (i) WSG-ADAPT-TN; (ii) MMJ-CAR-2014-01; and (iii) NeoPACT, including 527 patients with stage I-III TNBC undergoing neoadjuvant chemotherapy. In WSG-ADAPT-TN, patients were randomized to receive nab-paclitaxel plus gemcitabine or carboplatin. In MMJ-CAR-2014-01, patients received carboplatin plus docetaxel. In NeoPACT, patients received carboplatin plus docetaxel and pembrolizumab.

Results: TNBC-DX test was created incorporating the 10-gene Core Immune Gene module, the 4-gene tumor cell proliferation signature, tumor size, and nodal staging. In the two independent validation cohorts without pembrolizumab, the TNBC-DX pCR score was significantly associated with pCR after adjustment for clinicopathological variables and treatment regimen [odds ratio per 10-unit increment 1.34, 95% confidence interval (CI) 1.20-1.52, P < 0.001]. pCR rates for the TNBC-DX pCR-high, pCR-medium, and pCR-low categories were 56.3%, 53.6%, and 22.5% respectively (odds ratio for pCR-high versus pCR-low 3.48, 95% CI 1.72-7.15, P < 0.001). In addition, the TNBC-DX risk score was significantly associated with DDFS [hazard ratio (HR) high-risk versus low-risk 0.24, 95% CI 0.15-0.41, P < 0.001] and OS (HR 0.19, 95% CI 0.11-0.35, P < 0.001). In the validation cohort with pembrolizumab, the TNBC-DX scores were significantly associated with pCR, EFS, and OS.

Conclusions: TNBC-DX predicts pCR to neoadjuvant taxane-carboplatin in stage I-III TNBC and helps to forecast the patient's long-term survival in the absence of neoadjuvant anthracycline-cyclophosphamide, and independent of pembrolizumab use.

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来源期刊
Annals of Oncology
Annals of Oncology 医学-肿瘤学
CiteScore
63.90
自引率
1.00%
发文量
3712
审稿时长
2-3 weeks
期刊介绍: Annals of Oncology, the official journal of the European Society for Medical Oncology and the Japanese Society of Medical Oncology, offers rapid and efficient peer-reviewed publications on innovative cancer treatments and translational research in oncology and precision medicine. The journal primarily focuses on areas such as systemic anticancer therapy, with a specific emphasis on molecular targeted agents and new immune therapies. We also welcome randomized trials, including negative results, as well as top-level guidelines. Additionally, we encourage submissions in emerging fields that are crucial to personalized medicine, such as molecular pathology, bioinformatics, modern statistics, and biotechnologies. Manuscripts related to radiotherapy, surgery, and pediatrics will be considered if they demonstrate a clear interaction with any of the aforementioned fields or if they present groundbreaking findings. Our international editorial board comprises renowned experts who are leaders in their respective fields. Through Annals of Oncology, we strive to provide the most effective communication on the dynamic and ever-evolving global oncology landscape.
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