In:
Cancer Medicine, Wiley, Vol. 8, No. 4 ( 2019-04), p. 1755-1764
Abstract:
CanAssist‐Breast ( CAB ) is an immunohistochemistry ( IHC )‐based prognostic test for early‐stage Hormone Receptor ( HR +)‐positive breast cancer patients. CAB uses a Support Vector Machine ( SVM ) trained algorithm which utilizes expression levels of five biomarkers ( CD 44, ABCC 4, ABCC 11, N‐Cadherin, and Pan‐Cadherin) and three clinical parameters such as tumor size, grade, and node status as inputs to generate a risk score and categorizes patients as low‐ or high‐risk for distant recurrence within 5 years of diagnosis. In this study, we present clinical validation of CAB . CAB was validated using a retrospective cohort of 857 patients. All patients were treated either with endocrine therapy or chemoendocrine therapy. Risk categorization by CAB was analyzed by calculating Distant Metastasis‐Free Survival ( DMFS ) and recurrence rates using Kaplan‐Meier survival curves. Multivariate analysis was performed to calculate Hazard ratios ( HR ) for CAB high‐risk vs low‐risk patients. The results showed that Distant Metastasis‐Free Survival ( DMFS ) was significantly different ( P ‐0.002) between low‐ ( DMFS : 95%) and high‐risk ( DMFS : 80%) categories in the endocrine therapy treated alone subgroup (n = 195) as well as in the total cohort (n = 857, low‐risk DMFS : 95%, high‐risk DMFS : 84%, P 〈 0.0001). In addition, the segregation of the risk categories was significant ( P = 0.0005) in node‐positive patients, with a difference in DMFS of 12%. In multivariate analysis, CAB risk score was the most significant predictor of distant recurrence with hazard ratio of 3.2048 ( P 〈 0.0001). CAB stratified patients into discrete risk categories with high statistical significance compared to Ki‐67 and IHC 4 score‐based stratification. CAB stratified a higher percentage of the cohort (82%) as low‐risk than IHC 4 score (41.6%) and could re‐stratify 〉 74% of high Ki‐67 and IHC 4 score intermediate‐risk zone patients into low‐risk category. Overall the data suggest that CAB can effectively predict risk of distant recurrence with clear dichotomous high‐ or low‐risk categorization.
Type of Medium:
Online Resource
ISSN:
2045-7634
,
2045-7634
DOI:
10.1002/cam4.2019.8.issue-4
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2659751-2
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