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The STAR score predicts prognosis in Luminal-like breast cancer patients independently from dose-dense adjuvant chemotherapy

2016; Elsevier BV; Volume: 27; Linguagem: Inglês

10.1093/annonc/mdw337.17

1569-8041

Caterina Fontanella, Lucia Del Mastro, Sabino De Placido, Michelino De Laurentiis, C. Boni, Giovanna Carrà, Antonio Durando, Anna Turletti, A. Turletti, Cecilia Nisticò, Elisabetta Della Valle, O. Garrone, Filippo Montemurro, Sandro Barni, Andrea Ardizzoni, Teresa Gamucci, Giuseppe Colantuoni, C. Bighin, F. Cognetti, Fabio Puglisi,

Cancer Treatment and Pharmacology

Background: At the 2016 ASCO meeting we presented the prognostic STAR score, designed in a dataset of 4,646 pts with Luminal-like (HER2-/estrogen receptor [ER]+) early breast cancer (BC) combining tumor stage (AJCC Cancer Staging 7th), progesterone receptor [PR] status, and age at baseline. In this study we explored the prognostic value of the STAR score in the adjuvant GIM2 trial dataset, according to chemotherapy dose density. Methods: We analyzed 1,610 pts with Luminal-like BC from the 2x2 factorial randomized GIM2 trial (Del Mastro L, Lancet 2015) investigating dose-dense chemotherapy (ddCT) and the of addition of 5FU to epirubicin-cyclophosphamide regimen. All patients received adjuvant endocrine treatment and radiotherapy (if indicated). We used uni/multivariate Cox regression analyses to explore the effect of the score on disease-free (DFS) and overall survival (OS) according with chemotherapy dose-intensity. Results: The univariate analysis demonstrated that the STAR score discriminates 5 groups of Luminal-like BC patients with ifferent prognosis (DFS: standard CT p < 0.001 and ddCT p = <0.001; OS: standard CT p < 0.001 and ddCT p < 0.001). The results of the multivariate analysis adjusted for tumor grade (grade1 vs. grade2-3), Ki67 (cut off 20%), and body mass index (new BMI cut off 30) are shown in the table. Conclusion: The STAR score using stage at diagnosis, PR status and age discriminates Luminal-like BC with worse prognosis, independently from chemotherapy dose density.Table: F17STANDARD CTddCTDFSOSDFSOSHR95%CIpHR95%CIpHR95%CIpHR95%CIpSTAR SCOREEStage IIIC1.01.01.01.0DI-IIA/PR-/age < 400.500.28-0.890.0180.520.24-1.120.0960.450.28-0.730.0010.490.27-0.900.028IIB/PR-/any ageIIIA-B/PR + /age < 40IIIA-B/PR-/any ageCI-IIA/PR-/age ≥ 400.280.17-0.48<0.0010.340.17-0.680.0040.300.19-0.47<0.0010.260.14-0.47<0.001I-IIA/PR + /age < 40IIB/PR + /age < 40IIIA-B/PR + /age ≥ 40BIIB/PR + /age ≥ 400.260.14-0.51<0.0010.250.10-0.340.0020.210.12-0.39<0.0010.220.10-0.49<0.001AI-IIA/PR + /age ≥ 400.180.09-0.30<0.0010.150.06-0.35<0.0010.070.03-0.14<0.0010.030.01-0.12<0.001GRADE 1 vs 2-34.120.57-29.890.1610.910.21-3.830.8932.170.68-6.840.1873.760.52-27.520.191Ki67 <20% vs ≥20%1.340.91-1.990.1431.460.45-2.450.1681.320.93-1.860.1221.380.86-2.210.177New BMI <30 vs ≥301.050.65-1.700.8500.810.39-1.670.5681.130.67-1.670.5211.010.64-1.830.777 Open table in a new tab