Utility of the CPS+EG staging system in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer treated with neoadjuvant chemotherapy

Publication date: January 2016
Source:European Journal of Cancer, Volume 53
Author(s): Frederik Marmé, Bianca Lederer, Jens-Uwe Blohmer, Serban Dan Costa, Carsten Denkert, Holger Eidtmann, Bernd Gerber, Claus Hanusch, Jörn Hilfrich, Jens Huober, Christian Jackisch, Sherko Kümmel, Sibylle Loibl, Stefan Paepke, Michael Untch, Gunter von Minckwitz, Andreas Schneeweiss
BackgroundPathologic complete response after neoadjuvant chemotherapy (NACT) correlates with overall survival (OS) in primary breast cancer. A recently described staging system based on pre-treatment clinical stage (CS), final pathological stage (PS), estrogen receptor (ER) status and nuclear grade (NG) leads to a refined estimation of prognosis in unselected patients. Its performance in luminal type breast cancers has not been determined. This study investigates the clinical utility of this CPS+EG score when restricted to hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2–) patients and compares the results to a cohort of unselected patients.MethodsThe CPS+EG score was calculated for 6637 unselected patients and 2454 patients with HR+/HER2− tumours who received anthracycline/taxane-based NACT within 8 prospective German trials.ResultsFive-year disease-free survival (DFS) and OS were 75.6% and 84.1% for the unselected cohort and 80.6% and 87.8% for the HR+/HER2− subgroup, respectively. The CPS+EG system distinguished different prognostic groups with 5-year DFS ranging from 0% to 91%. The CPS+EG system leads to an improved categorisation of patients by outcome compared to CS, PS, ER or NG alone. When applying the CPS+EG score to the HR+/HER2− subgroup, a shift to lower scores was observed compared to the overall population, but 5-year DFS and OS for the individual scores were identical to that observed in the overall population.ConclusionsIn HR+/HER2− patients, the CPS+EG staging system retains its ability to facilitate a refined stratification of patients according to outcome. It can help to select candidates for post-neoadjuvant clinical trials in luminal breast cancer.



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