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Prediction of Late Disease Recurrence and Extended Adjuvant Letrozole Benefit by the HOXB13/IL17BR Biomarker
Open accessAbstract
BACKGROUND: Biomarkers to optimize extended adjuvant endocrine therapy for women with estrogen receptor (ER)-positive breast cancer are limited. The HOXB13/IL17BR (H/I) biomarker predicts recurrence risk in ER-positive, lymph node-negative breast cancer patients. H/I was evaluated in MA.17 trial for prognostic performance for late recurrence and treatment benefit from extended adjuvant letrozole. METHODS: A prospective-retrospective, nested case-control design of 83 recurrences matched to 166 nonrecurrences from letrozole- and placebo-treated patients within MA.17 was conducted. Expression of H/I within primary tumors was determined by reverse-transcription polymerase chain reaction with a prespecified cutpoint. The predictive ability of H/I for ascertaining benefit from letrozole was determined using multivariable conditional logistic regression including standard clinicopathological factors as covariates. All statistical tests were two-sided. RESULTS: High H/I was statistically significantly associated with a decrease in late recurrence in patients receiving extended letrozole therapy (odds ratio [OR] = 0.35; 95% confidence interval [CI] = 0.16 to 0.75; P = .007). In an adjusted model with standard clinicopathological factors, high H/I remained statistically significantly associated with patient benefit from letrozole (OR = 0.33; 95% CI = 0.15 to 0.73; P = .006). Reduction in the absolute risk of recurrence at 5 years was 16.5% for patients with high H/I (P = .007). The interaction between H/I and letrozole treatment was statistically significant (P = .03). CONCLUSIONS: In the absence of extended letrozole therapy, high H/I identifies a subgroup of ER-positive patients disease-free after 5 years of tamoxifen who are at risk for late recurrence. When extended endocrine therapy with letrozole is prescribed, high H/I predicts benefit from therapy and a decreased probability of late disease recurrence.
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Cited by
Duffy, M. J., Harbeck, N., Nap, M., Molina, R., Nicolini, A., Senkus, E., & Cardoso, F. (2017) · European Journal of Cancer · doi:10.1016/j.ejca.2017.01.017 · Cited by 522
Spring, L. M., Gupta, A., Reynolds, K. L., Gadd, M. A., Ellisen, L. W., Isakoff, S. J., Moy, B., & Bardia, A. (2016) · JAMA Oncology · doi:10.1001/jamaoncol.2016.1897 · Cited by 396
Metastasis Dormancy in Estrogen Receptor–Positive Breast Cancer
Zhang, X. H.-F., Giuliano, M., Trivedi, M. V., Schiff, R., & Osborne, C. K. (2013) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-13-0838 · Cited by 264
Metadata
- Authors
- Sgroi, D. C., Carney, E., Zarrella, E., Steffel, L., Binns, S. N., Finkelstein, D. M., Szymonifka, J., Bhan, A. K., Shepherd, L. E., Zhang, Y., Schnabel, C. A., Erlander, M. G., Ingle, J. N., Porter, P., Muss, H. B., Pritchard, K. I., Tu, D., Rimm, D. L., & Goss, P. E.
- Venue
- JNCI: Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-07-13
- Volume
- 105
- Issue
- 14
- Pages
- 1036-1042
- ISSN
- 0027-8874 (ISSN-L)
- 1460-2105
- OpenAlex
- W2159216027
- Cited by
- 229
- References
- 0
- FWCI
- 4.97
- Type
- journal article
- Language
- en
- Open access
- hybrid
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- Sgroi, D. C., Carney, E., Zarrella, E., Steffel, L., Binns, S. N., Finkelstein, D. M., Szymonifka, J., Bhan, A. K., Shepherd, L. E., Zhang, Y., Schnabel, C. A., Erlander, M. G., Ingle, J. N., Porter, P., Muss, H. B., Pritchard, K. I., Tu, D., Rimm, D. L., & Goss, P. E. (2013). Prediction of Late Disease Recurrence and Extended Adjuvant Letrozole Benefit by the HOXB13/IL17BR Biomarker. JNCI: Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djt146
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