title: Prognostic utility of HOXB13:IL17BR and molecular grade index in early-stage breast cancer patients from the Stockholm trial.
abstract: BACKGROUND
  A dichotomous index combining two gene expression assays, HOXB13:IL17BR (H:I) and molecular grade index (MGI), was developed to assess risk of recurrence in breast cancer patients. The study objective was to demonstrate the prognostic utility of the combined index in early-stage breast cancer.
  
  
  METHODS
  In a blinded retrospective analysis of 588 ER-positive tamoxifen-treated and untreated breast cancer patients from the randomised prospective Stockholm trial, H:I and MGI were measured using real-time RT-PCR. Association with patient outcome was evaluated by Kaplan-Meier analysis and Cox proportional hazard regression. A continuous risk index was developed using Cox modelling.
  
  
  RESULTS
  The dichotomous H:I+MGI was significantly associated with distant recurrence and breast cancer death. The >50% of tamoxifen-treated patients categorised as low-risk had <3% 10-year distant recurrence risk. A continuous risk model (Breast Cancer Index (BCI)) was developed with the tamoxifen-treated group and the prognostic performance tested in the untreated group was 53% of patients categorised as low risk with an 8.3% 10-year distant recurrence risk.
  
  
  CONCLUSIONS
  Retrospective analysis of this randomised, prospective trial cohort validated the prognostic utility of H:I+MGI and was used to develop and test a continuous risk model that enables prediction of distant recurrence risk at the patient level.
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Oncology, Faculty of Health Sciences, Linköping University, Linköping, SE58185, Sweden. piiha-lotta.jerevall@liu.se
authors.forename: P-L
authors.initials: PL
authors.lastname: Jerevall
authors.forename: X-J
authors.initials: XJ
authors.lastname: Ma
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: R
authors.initials: R
authors.lastname: Salunga
authors.forename: N C
authors.initials: NC
authors.lastname: Kesty
authors.forename: M G
authors.initials: MG
authors.lastname: Erlander
authors.forename: D C
authors.initials: DC
authors.lastname: Sgroi
authors.forename: B
authors.initials: B
authors.lastname: Holmlund
authors.forename: L
authors.initials: L
authors.lastname: Skoog
authors.forename: T
authors.initials: T
authors.lastname: Fornander
authors.forename: B
authors.initials: B
authors.lastname: Nordenskjöld
authors.forename: O
authors.initials: O
authors.lastname: Stål
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D018398:Homeodomain Proteins / Q000032:analysis*; D006801:Humans; D009362:Neoplasm Metastasis; D009376:Neoplasms, Hormone-Dependent / Q000175:diagnosis; D017698:Postmenopause; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018123:Receptors, Interleukin / Q000032:analysis*; D053722:Receptors, Interleukin-17; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018570:Risk Assessment; D013548:Sweden; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D014408:Biomarkers, Tumor; C484414:HOXB13 protein, human; D018398:Homeodomain Proteins; C408922:IL17RB protein, human; D018123:Receptors, Interleukin; D053722:Receptors, Interleukin-17; D013629:Tamoxifen