http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:12497 Estrogen receptor (ER) positive primary breast cancers have a wide range of clinical outcomes. Prediction of the likely course of the disease aids treatment decision-making. In the translational arm of the ATAC (anastrozole or tamoxifen alone or combined) trial (TransATAC) we have assessed individual and multiparameter biomarkers for their prediction of overall and distant recurrence. None of the biomarkers identified differential benefit for anastrozole versus tamoxifen. Each of ER, PgR, HER2 and Ki67 was associated with risk of recurrence. A combination of these to create a single predictor IHC4 was as informative as the 21-gene recurrence score (RS). Integration of each of these molecular profiles with classical clinicopathologic variables provided the most accurate prediction of outcome. 2013-01-29T23:50:04.645Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:11225 Purpose: To determine whether the Recurrence Score (RS) provided independent information on risk of distant recurrence (DR) in the tamoxifen and anastrozole arms of the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trial. Patients and Methods: RNA was extracted from 1,372 tumor blocks from postmenopausal patients with hormone receptor positive primary breast cancer in the monotherapy arms of ATAC. Twenty-one genes were assessed by quantitative reverse transcriptase polymerase chain reaction, and the RS was calculated. Cox proportional hazards models assessed the value of adding AS to a model with clinical variables (age, tumor size, grade, and treatment) in node-negative (NO) and node-positive (N+) women. Results: Reportable scores were available from 1,231 evaluable patients (NO, n = 872; N+, n = 306; and node status unknown, n = 53); 72, 74, and six DRs occurred in NO, N+, and node status unknown patients, respectively. For both NO and N+ patients, AS was significantly associated with time to DR in multivariate analyses (P < .001 for NO and P = .002 for N+). AS also showed significant prognostic value beyond that provided by Adjuvant! Online (P < .001). Nine-year DR rates in low (RS < 18), intermediate (RS = 18 to 30), and high RS (RS≥31) groups were 4%, 12%, and 25%, respectively, in NO patients and 17%, 28%, and 49%, respectively, in N+ patients. The prognostic value of AS was similar in anastrozole- and tamoxifen-treated patients. Conclusion: This study confirmed the performance of AS in postmenopausal HR+ patients treated with tamoxifen in a large contemporary population and demonstrated that AS is an independent predictor of DR in NO and N+ hormone receptor positive patients treated with anastrozole, adding value to estimates with standard clinicopathologic features. 2012-08-10T03:23:05.164Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5453 Purpose: To determine the relationship between quantitative estrogen-receptor (ER) and progesterone-receptor (PgR) expression and human epidermal growth factor 2 (HER-2) status with time to recurrence (TTR) in postmenopausal women with hormone receptor–positive primary breast cancer treated with anastrozole or tamoxifen as adjuvant therapy. Patients and Methods: Formalin-fixed, paraffin-embedded tumor blocks were retrospectively collected from patients in the monotherapy arms of the Arimidex, Tamoxifen Alone or in Combination (ATAC) trial and centrally tested for ER, PgR and HER-2. ER and PgR were scored using continuous scales and HER-2 was scored as 0 to 3+ with 2+ cases being analyzed by fluorescence in situ hybridization. Results: Blocks were collected from 2,006 of 5,880 eligible patients. Tissue was assessable and ER and/or PgR positivity confirmed centrally in 1,782 cases. In these, TTR was longer for anastrozole than for tamoxifen by a similar extent to that in the overall trial. None of the three biomarkers identified a set of patients with differential benefit from anastrozole over tamoxifen. Patients with low ER, low PgR, and high HER-2 expression had a poorer prognosis with either drug. Only 2.6% of patients in the highest quartile of PgR experienced recurrence after 5 years, compared with 13.2% in the lowest quartile. Conclusion: Quantitative expression of ER and PgR and HER-2 status did not identify patients with differential relative benefit from anastrozole over tamoxifen: TTR was longer for anastrozole than for tamoxifen in all molecular subgroups. Low ER or PgR or high HER-2 expression are associated with a high risk of recurrence with either anastrozole or tamoxifen. 2010-04-27T04:48:15.627Z ]]>