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EndoPredict predicts chemo benefit in ER-positive HER2-negative breast cancer

EndoPredict (EPclin) score can predict chemotherapy benefit in women with oestrogen receptor (ER)-positive, HER2-negative breast cancer, according to a new study led by Queen Mary University of London.

The study determined the performance of EPclin for estimating 10-year distant recurrence (DR) risk for those who received adjuvant endocrine therapy (ET) alone compared to chemotherapy plus endocrine therapy (ET + C). A total of 3746 women were included in the analysis, of whom 2630 received five years of ET alone and 1116 received ET + C therapy.

Women receiving ET alone had a median follow-up time of 9.6 years (interquartile range [IQR], 6-10). A total of 279 DR events (10.6%) were recorded for these women over a 10-year follow-up period and 120 (5.5%) late DR events (years 5-10). Median time to DR for women receiving ET + C was nine years (IQR, 7-10) with a total of 146 (13%) DR events recorded, with 53 (5.2%) late DR events.

EPclin was highly prognostic in women who received ET alone (HR, 2.79; 95% CI, 2.49-3.13; P<.0001) as well as in those who received ET + C (HR, 2.27; 95% CI, 1.99-2.59; P<.0001) in a univariate analysis.

The results indicate that women with high EPclin scores benefitted from chemotherapy compared to those with the same EPclin score but receiving ET alone, irrespective of node-positivity of the disease. There was a significant positive interaction between EPclin and treatment groups (P-interaction=.022).

Commenting on the findings in the journal Breast Cancer Research and Treatment, the authors said the results indicate that “many women with low EPclin scores were likely to have been over-treated with chemotherapy and that many women with high EPclin scores may not have received necessary chemotherapy treatment”.


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