Prediction of Late Disease Recurrence and Extended Adjuvant Letrozole Benefit by the HOXB13/IL17BR Biomarker
Year: 2013
Type: article
Abstract: 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.
DOI: 10.1093/jnci/djt146
Authors: Dennis C. Sgroi, Erin Carney, Elizabeth Zarrella, Lauren Steffel, Shemeica N. Binns, Dianne M. Finkelstein, Jackie Szymonifka, Atul K. Bhan, Lois E. Shepherd, Yi Zhang, Catherine A. Schnabel, Mark G. Erlander, James N. Ingle, Peggy Porter, Hyman B. Muss, Katherine I. Pritchard, Dongsheng Tu, David L. Rimm, Paul E. Goss
Institutions: University of North Carolina at Chapel Hill, Sunnybrook Health Science Centre, Mayo Clinic, University of Toronto, Queen's University, Yale University, Massachusetts General Hospital, Fred Hutch Cancer Center, UNC Lineberger Comprehensive Cancer Center, Canadian Cancer Trials Group, Odette Cancer Centre
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $5,436
OpenAlex ID: W2159216027