Evaluation of the 12-Gene Molecular Score and the 21-Gene Recurrence Score as Predictors of Response to Neo-adjuvant Chemotherapy in Estrogen Receptor-Positive, HER2-Negative Breast Cancer

Hatem Soliman, Susanne Wagner, Darl D. Flake, Mark Robson, Lee Schwartzberg, Priyanka Sharma, Anthony Magliocco, Ralf Kronenwett, Johnathan M. Lancaster, Jerry S. Lanchbury, Alexander Gutin, William Gradishar*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Neo-adjuvant chemotherapy (NaCT) facilitates complete surgical resection in locally advanced breast cancer. Due to its association with improved outcome, complete pathologic response (pCR) to neo-adjuvant treatment has been accepted as a surrogate for long-term outcome in clinical trials of human epidermal growth factor receptor 2 (HER2)-positive, triple-negative, or luminal B breast cancer patients. In contrast, NaCT is effective in only ~ 7–10% of estrogen receptor (ER)-positive, HER2-negative disease. Response biomarkers would enable such patients to be selected for NaCT. Methods: Two commercially available breast cancer prognostic signatures [12-gene molecular score (MS) and the 21-gene Recurrence Score (RS)] were compared in their ability to predict pCR to NaCT in ER-positive, HER2-negative breast cancer in six public RNA expression microarray data sets. Scores were approximated according to published algorithms and analyzed by logistic regression. Results: Expression data were available for 764 ER-positive, HER2-negative breast cancer samples, including 59 patients with pCR. The two scores were well correlated. Either score was a significant predictor of pCR (12-gene MS p = 9.4 × 10−5; 21-gene RS p = 0.0041). However, in a model containing both scores, the 12-gene MS remained significant (p = 0.0079), while the 21-gene RS did not (p = 0.79). Conclusions: In this microarray study, two commercial breast cancer prognostic scores were significant predictors of response to NaCT. In direct comparison, the 12-gene MS outperformed the 21-gene RS as a predictive marker for NaCT. Considering pCR as surrogate for improved survival, these results support the ability of both scores to predict chemotherapy sensitivity.

Original languageEnglish (US)
Pages (from-to)765-771
Number of pages7
JournalAnnals of surgical oncology
Volume27
Issue number3
DOIs
StatePublished - Mar 1 2020

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Soliman, H., Wagner, S., Flake, D. D., Robson, M., Schwartzberg, L., Sharma, P., Magliocco, A., Kronenwett, R., Lancaster, J. M., Lanchbury, J. S., Gutin, A., & Gradishar, W. (2020). Evaluation of the 12-Gene Molecular Score and the 21-Gene Recurrence Score as Predictors of Response to Neo-adjuvant Chemotherapy in Estrogen Receptor-Positive, HER2-Negative Breast Cancer. Annals of surgical oncology, 27(3), 765-771. https://doi.org/10.1245/s10434-019-08039-7