High recurrence score associated with other high-risk factors

San Antonio Breast Cancer Symposium

SAN ANTONIO — High-risk status, according to the recurrence score multi-gene assay, is predictive of high risk measured by uPA/PAI-1, high-grade central pathology and luminal B subtype, researchers reported here.

Oleg Gluz, MD, of the West German Study Group in Mönchengladbach, Germany, presented the final correlation analysis from the phase 3 West German Study Group Plan B trial, in which the efficacy of anthracycline-free chemotherapy in HER-2–negative breast cancer was assessed after molecular-based assessment according to Oncotype DX and uPA/PAI-1.

“Adjuvant chemotherapy indication is mainly based on assessment of recurrence risk,” Gluz said. “Overtreatment is frequent in low- and intermediate-risk groups in HR-positive disease. This may be reduced by optimizing prognostic tools, including Ki-67, central grade and uPA/PAI-1.”

From April 2009 to June 2011, 3,037 patients were recruited and 2,290 patients were randomly assigned. Among 2,361 patients, 18% had a recurrence score of 0 to 11; 61% had a recurrence score of 12 to 25; and 21% had a recurrence score of more than 25. Data on central grade were available in 1,509 patients and data on Ki-67 were available in 592 patients.

There was a moderate positive correlation between Ki-67 and recurrence score (P,.001) and between recurrence score and central grade (P,.001). A high recurrence score predicted grade-3 tumors, but 30% to 33% of tumors within the low-risk recurrence score group were also grade 3. High-risk recurrence score is predictive of uPA/PAI-1, poor grade and luminal B subtype, but the converse is not true, Gluz said.

“High recurrence score usually implies high risk by central grade 3, luminal B subtype and high uPA/PAI-1,” he said. “However, risk assessment within low and intermediate recurrence score risk groups exhibits substantial heterogeneity according to central grade, luminal subtype and uPA/PAI-1. Outcome data are needed for definite statement regarding clinical significance of this heterogeneous risk group assessment.”

Disclosure: Dr. Gluz reports no relevant financial disclosures.

Earn CME this spring at the HemOnc Today Breast Cancer Review & Perspective meeting to be held March 23-24, 2012 at the Hilton San Diego Bayfront. See details at HemOncTodayBreastCancer.com.

For more information:

Gluz O. #S4-3. Presented at: the 2011 CTRC-AACR San Antonio Breast Cancer Symposium; Dec. 6-11, 2011; San Antonio.

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