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  • [Clin Cancer Res.] 유방관내상피세포에서 방사선치료 반응을 예측하고 위험도를 평가하기 위한 생물학적 시그니처 A Biological Signature for Breast Ductal Carcinoma In Situ to Predict Radiotherapy Benefit and Assess Recurrence Risk.

    Uppsala Academic / Troy Bremer*

  • 출처
    Clin Cancer Res.
  • 등재일
    2018 Dec 1
  • 저널이슈번호
    24(23):5895-5901. doi: 10.1158/1078-0432.CCR-18-0842. Epub 2018 Jul 27.
  • 내용

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    Abstract
    PURPOSE:
    Ductal carcinoma in situ (DCIS) patients and their physicians currently face challenging treatment decisions with limited information about the individual's subsequent breast cancer risk or treatment benefit. The DCISionRT biological signature developed in this study provides recurrence risk and predicts radiotherapy (RT) benefit for DCIS patients following breast-conserving surgery (BCS).

    EXPERIMENTAL DESIGN:
    A biological signature that calculates an individualized Decision Score (DS) was developed and cross-validated in 526 DCIS patients treated with BCS ± RT. The relationship was assessed between DS and 10-year risk of invasive breast cancer (IBC) or any ipsilateral breast event (IBE), including IBC or DCIS. RT benefit was evaluated by risk group and as a function of DS.

    RESULTS:
    The DS was significantly associated with IBC and IBE risk, HR (per 5 units) of 4.2 and 3.1, respectively. For patients treated without RT, DS identified a Low Group with 10-year IBC risk of 4% (7% IBE) and an Elevated Risk Group with IBC risk of 15% (23% IBE). In analysis of DS and RT by group, the Elevated Risk Group received significant RT benefit, HR of 0.3 for IBC and IBE. In a clinicopathologically low-risk subset, DS reclassified 42% of patients into the Elevated Risk Group. In an interaction analysis of DS and RT, patients with elevated DS had significant RT benefit over baseline.

    CONCLUSIONS:
    The DS was prognostic for risk and predicted RT benefit for DCIS patients. DS identified a clinically meaningful low-risk group and a group with elevated 10-year risks that received substantial RT benefit over baseline.

     


    Author information

    Bremer T1, Whitworth PW2, Patel R3, Savala J4, Barry T5, Lyle S6, Leesman G4, Linke SP7, Jirström K8, Zhou W9, Amini RM10, Wärnberg F11.
    1
    PreludeDx, Laguna Hills, California. tbremer@preludedx.com Fredrik.Warnberg@surgsci.uu.se.
    2
    Nashville Breast Center, Nashville, Tennessee.
    3
    Good Samaritan Cancer Center, Los Gatos, California.
    4
    PreludeDx, Laguna Hills, California.
    5
    Spectrum Pathology, Inc., Mission Viejo, California.
    6
    University of Massachusetts Medical School, Worcester, Massachusetts.
    7
    Steven P. Linke Consulting, Carlsbad, California.
    8
    Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden.
    9
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    10
    Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
    11
    Department of Surgical Sciences, Uppsala University, Department of Surgery, Uppsala Academic Hospital, Uppsala, Sweden. tbremer@preludedx.com Fredrik.Warnberg@surgsci.uu.se.

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