title: Predictive algorithms for adjuvant therapy: TransATAC.
abstract: 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.
authors.affiliation: Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Road, London SW36JJ, UK. mitch.dowsett@icr.ac.uk
authors.forename: Mitch
authors.initials: M
authors.lastname: Dowsett
authors.forename: Janine
authors.initials: J
authors.lastname: Salter
authors.forename: Lila
authors.initials: L
authors.lastname: Zabaglo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mallon
authors.forename: Antony
authors.initials: A
authors.lastname: Howell
authors.forename: Aman U
authors.initials: AU
authors.lastname: Buzdar
authors.forename: John
authors.initials: J
authors.lastname: Forbes
authors.forename: S
authors.initials: S
authors.lastname: Pineda
authors.forename: Jack
authors.initials: J
authors.lastname: Cuzick
mesh_terms: D000465:Algorithms; D000077384:Anastrozole; D000971:Antineoplastic Combined Chemotherapy Protocols; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000235:genetics; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009570:Nitriles / Q000627:therapeutic use*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D011960:Receptors, Estrogen / Q000235:genetics / Q000378:metabolism; D011980:Receptors, Progesterone / Q000235:genetics; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D000077384:Anastrozole; D047072:Aromatase Inhibitors; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009570:Nitriles; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013629:Tamoxifen; D014230:Triazoles; C508053:ERBB2 protein, human