Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study

Abstract Multiparametric assays for risk stratification are widely used in the management of both node negative and node positive hormone receptor positive invasive breast cancer. Recent data from multiple sources suggests that different tests may provide different risk estimates at the individual p...

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Autores principales:	John M. S. Bartlett, Jane Bayani, Elizabeth Kornaga, Keying Xu, Greg R. Pond, Tammy Piper, Elizabeth Mallon, Cindy Q. Yao, Paul C. Boutros, Annette Hasenburg, J. A. Dunn, Christos Markopoulos, Luc Dirix, Caroline Seynaeve, Cornelis J. H. van de Velde, Robert C. Stein, Daniel Rea
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/86050652dddb40c7bbae488c081d3af4
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spelling	oai:doaj.org-article:86050652dddb40c7bbae488c081d3af42021-12-02T16:14:48ZComparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study10.1038/s41523-021-00297-72374-4677https://doaj.org/article/86050652dddb40c7bbae488c081d3af42021-07-01T00:00:00Zhttps://doi.org/10.1038/s41523-021-00297-7https://doaj.org/toc/2374-4677Abstract Multiparametric assays for risk stratification are widely used in the management of both node negative and node positive hormone receptor positive invasive breast cancer. Recent data from multiple sources suggests that different tests may provide different risk estimates at the individual patient level. The TEAM pathology study consists of 3284 postmenopausal ER+ve breast cancers treated with endocrine therapy Using genes comprising the following multi-parametric tests OncotypeDx®, Prosigna™ and MammaPrint® signatures were trained to recapitulate true assay results. Patients were then classified into risk groups and survival assessed. Whilst likelihood χ 2 ratios suggested limited value for combining tests, Kaplan–Meier and LogRank tests within risk groups suggested combinations of tests provided statistically significant stratification of potential clinical value. Paradoxically whilst Prosigna-trained results stratified Oncotype-trained subgroups across low and intermediate risk categories, only intermediate risk Prosigna-trained cases were further stratified by Oncotype-trained results. Both Oncotype-trained and Prosigna-trained results further stratified MammaPrint-trained low risk cases, and MammaPrint-trained results also stratified Oncotype-trained low and intermediate risk groups but not Prosigna-trained results. Comparisons between existing multiparametric tests are challenging, and evidence on discordance between tests in risk stratification presents further dilemmas. Detailed analysis of the TEAM pathology study suggests a complex inter-relationship between test results in the same patient cohorts which requires careful evaluation regarding test utility. Further prognostic improvement appears both desirable and achievable.John M. S. BartlettJane BayaniElizabeth KornagaKeying XuGreg R. PondTammy PiperElizabeth MallonCindy Q. YaoPaul C. BoutrosAnnette HasenburgJ. A. DunnChristos MarkopoulosLuc DirixCaroline SeynaeveCornelis J. H. van de VeldeRobert C. SteinDaniel ReaNature PortfolioarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENnpj Breast Cancer, Vol 7, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 John M. S. Bartlett Jane Bayani Elizabeth Kornaga Keying Xu Greg R. Pond Tammy Piper Elizabeth Mallon Cindy Q. Yao Paul C. Boutros Annette Hasenburg J. A. Dunn Christos Markopoulos Luc Dirix Caroline Seynaeve Cornelis J. H. van de Velde Robert C. Stein Daniel Rea Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study
description	Abstract Multiparametric assays for risk stratification are widely used in the management of both node negative and node positive hormone receptor positive invasive breast cancer. Recent data from multiple sources suggests that different tests may provide different risk estimates at the individual patient level. The TEAM pathology study consists of 3284 postmenopausal ER+ve breast cancers treated with endocrine therapy Using genes comprising the following multi-parametric tests OncotypeDx®, Prosigna™ and MammaPrint® signatures were trained to recapitulate true assay results. Patients were then classified into risk groups and survival assessed. Whilst likelihood χ 2 ratios suggested limited value for combining tests, Kaplan–Meier and LogRank tests within risk groups suggested combinations of tests provided statistically significant stratification of potential clinical value. Paradoxically whilst Prosigna-trained results stratified Oncotype-trained subgroups across low and intermediate risk categories, only intermediate risk Prosigna-trained cases were further stratified by Oncotype-trained results. Both Oncotype-trained and Prosigna-trained results further stratified MammaPrint-trained low risk cases, and MammaPrint-trained results also stratified Oncotype-trained low and intermediate risk groups but not Prosigna-trained results. Comparisons between existing multiparametric tests are challenging, and evidence on discordance between tests in risk stratification presents further dilemmas. Detailed analysis of the TEAM pathology study suggests a complex inter-relationship between test results in the same patient cohorts which requires careful evaluation regarding test utility. Further prognostic improvement appears both desirable and achievable.
format	article
author	John M. S. Bartlett Jane Bayani Elizabeth Kornaga Keying Xu Greg R. Pond Tammy Piper Elizabeth Mallon Cindy Q. Yao Paul C. Boutros Annette Hasenburg J. A. Dunn Christos Markopoulos Luc Dirix Caroline Seynaeve Cornelis J. H. van de Velde Robert C. Stein Daniel Rea
author_facet	John M. S. Bartlett Jane Bayani Elizabeth Kornaga Keying Xu Greg R. Pond Tammy Piper Elizabeth Mallon Cindy Q. Yao Paul C. Boutros Annette Hasenburg J. A. Dunn Christos Markopoulos Luc Dirix Caroline Seynaeve Cornelis J. H. van de Velde Robert C. Stein Daniel Rea
author_sort	John M. S. Bartlett
title	Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study
title_short	Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study
title_full	Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study
title_fullStr	Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study
title_full_unstemmed	Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study
title_sort	comparative survival analysis of multiparametric tests—when molecular tests disagree—a team pathology study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/86050652dddb40c7bbae488c081d3af4
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Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study

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