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27-07-2022 | Breast Cancer | Breast Oncology

Expanding the Staging Criteria for T1-2N0 Hormone-Receptor Positive Breast Cancer Patients Enrolled in TAILORx

Authors: Olga Kantor, MD, MS, Harold J. Burstein, MD, PhD, Tari A. King, MD, Steven Shak, MD, Christy A. Russell, MD, Armando E. Giuliano, MD, Gabriel N. Hortobagyi, MD, Eric P. Winer, MD, Larissa A. Korde, MD, MPH, Joseph A. Sparano, MD, Elizabeth A. Mittendorf, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2022

Abstract

Background

The American Joint Committee on Cancer (AJCC) 8th edition pathologic prognostic staging (PPS) incorporates anatomic and biologic factors. The OncotypeDX Breast Recurrence Score (RS) was included based on the initial report of the TAILORx trial, with T1-2N0 hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer patients who had a RS < 11 staged as PPS 1A. This study examined whether the RS criteria for PPS 1A can be further expanded using patients enrolled in the TAILORx trial.

Methods

The TAILORx trial enrolled 10,273 HR+HER2− T1-2N0 patients. Those with incomplete HR-status/grade and T3 disease were excluded for analysis. The recurrence-free interval (RFI) was compared between the patients who did and those who did not fall into the current PPS 1A category using the Kaplan-Meier method.

Results

The study enrolled 9535 patients for analysis. The RS was < 11 in 16.1%, 11–17 in 35.9%, 18–25 in 32.4%, and > 25 in 15.6% of the patients. The majority (91.2%) of the patients (including all the T1N0 patients regardless of RS) were PPS 1A, and 8.8% were not-PPS 1A. The median follow-up time was 95 months. The PPS 1A patients had an 8-year RFI of 94.2%, which was similar to that of the patients with a RS of 11–17 who were not-PPS 1A (91.7%; p = 0.07) and better than that of the patients with a RS ≥ 18 who were not-PPS 1A (85.4% for a RS of 18–25, 76.0% for a RS > 25; both p < 0.01). Similar RFI trends were seen in patients who received endocrine therapy or chemotherapy followed by endocrine therapy.

Conclusions

Patients with T1-2N0 HR+HER2− breast cancer and a RS < 18 have an RFI similar to that of patients staged as PPS 1A by the current AJCC staging system, regardless of treatment, suggesting that the criteria for PPS 1A can be expanded to include a RS < 18.

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Title: Expanding the Staging Criteria for T1-2N0 Hormone-Receptor Positive Breast Cancer Patients Enrolled in TAILORx
Authors: Olga Kantor, MD, MS
Harold J. Burstein, MD, PhD
Tari A. King, MD
Steven Shak, MD
Christy A. Russell, MD
Armando E. Giuliano, MD
Gabriel N. Hortobagyi, MD
Eric P. Winer, MD
Larissa A. Korde, MD, MPH
Joseph A. Sparano, MD
Elizabeth A. Mittendorf, MD, PhD
Publication date: 27-07-2022
Publisher: Springer International Publishing
Keywords: Breast Cancer
Breast Cancer
Published in: Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-022-12225-5

At a glance: The STEP trials

Springer Medicine

Expanding the Staging Criteria for T1-2N0 Hormone-Receptor Positive Breast Cancer Patients Enrolled in TAILORx

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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