Comparing Genetic Risk and Clinical Risk Classification in Luminal-like Breast Cancer Patients Using a 23-Gene Classifier
by
, ,
Chi-Cheng Huang
1,2,†
,
Ting-Hao Chen
2,3,†,
Liang-Chih Liu
4,5,
Chiun-Sheng Huang
6,
Ji-An Liang
7,
Yu-Chen Hsu
8,
Chia-Ming Hsieh
9,
Sean-Lin Huang
3,
Kuan-Hui Shih
3,* and
Ling-Ming Tseng
1,10,* 1
Comprehensive Breast Health Center, Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan
2
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106170, Taiwan
3
Amwise Diagnostics Pte. Ltd., Singapore 069547, Singapore
4
Department of General Surgery, China Medical University Hospital, Taichung 40454, Taiwan
5
College of Medicine, China Medical University, Taichung 40402, Taiwan
6
Department of Surgery, National Taiwan University Hospital, Taipei 300600, Taiwan
7
Department of Radiation Oncology, China Medical University Hospital, Taichung 40454, Taiwan
8
Department of General Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan
9
Department of General Surgery, Taiwan Adventist Hospital, Taipei 105520, Taiwan
10
Faculty of Medicine, College of Medicine, National Yang-Ming University, Taipei 112304, Taiwan
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Cancers 2022, 14(24), 6263; https://doi.org/10.3390/cancers14246263
Submission received: 4 October 2022
/
Revised: 13 December 2022
/
Accepted: 15 December 2022
/
Published: 19 December 2022
(This article belongs to the Special Issue Genomics and Bioinformatics Based Analysis of Cancer)
Simple Summary
Multi-gene expression assays have been advocated for treatment decision in breast cancer management. The most commonly used assays such as Oncotype DX, MammaPrint, which were developed from the Western population, were especially designed for the prognostication of early stage luminal-type breast cancer. The tabulation of multi-gene expression assay and clinical risk has become the research interest recently. The 23-gene signature was purposed for the Asian population and was validated for the discriminative ability regarding 5-year relapse-free survival and the objective of this study was to evaluate the performance across distinct clinical risk groups.
Abstract
Background: A 23-gene classifier has been developed based on gene expression profiles of Taiwanese luminal-like breast cancer. We aim to stratify risk of relapse and identify patients who may benefit from adjuvant chemotherapy based on genetic model among distinct clinical risk groups. Methods: There were 248 luminal (hormone receptor-positive and human epidermal growth factor receptor II-negative) breast cancer patients with 23-gene classifier results. Using the modified Adjuvant! Online definition, clinical high/low-risk groups were tabulated with the genetic model. The primary endpoint was a recurrence-free interval (RFI) at 5 years. Results: There was a significant difference between the high/low-risk groups defined by the 23-gene classifier for the 5-year prognosis of recurrence (16 recurrences in high-risk and 3 recurrences in low-risk; log-rank test: p < 0.0001). Among the clinically high-risk group, the 5-year RFI of high risk defined by the 23-gene classifier was significantly higher than that of the low-risk group (15 recurrences in high-risk and 2 recurrences in low-risk; log-rank test: p < 0.0001). Conclusion: This study showed that 23-gene classifier can be used to stratify clinically high-risk patients into distinct survival patterns based on genomic risks and displays the potentiality to guide adjuvant chemotherapy. The 23-gene classifier can provide a better estimation of breast cancer prognosis which can help physicians make a better treatment decision.
