Acharya CR et al. - Incorporation of gene expression signatures into clinical risk stratification can refine prognosis Methods
Retrospective study of early stage breast carcinoma candidates for adjuvant chemotherapy
Review of microarray data for 964 clinically annotated breast tumor samples (573 in initial set; 391 in validation cohort)
Relapse risk scores based on respective clinicopathologic features
Main outcome measures: gene expression signatures and clinicopathological variables in early stage breast cancer to determine a refined estimation of relapse-free survival and sensitivity to chemotherapy
Results
In initial 573 pts, prognostically significant clusters as patterns of oncogenic pathway activation and tumor biology/microenvironment states were identified within the low-, intermediate-, and high-risk model cohorts
Multivariate analyses confirmed independent prognostic value of genomic clusters
Related, not identical, clusters in the independent validation cohort established reproducibility and validity of pathway deregulation patterns in predicting relapse risk
The prognostic clinicogenomic clusters showed unique sensitivity patterns to commonly used cytotoxic therapies
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