title: The PAM50 risk-of-recurrence score predicts risk for late distant recurrence after endocrine therapy in postmenopausal women with endocrine-responsive early breast cancer.
abstract: OBJECTIVE
  To assess the prognostic value of the PAM50 risk-of-recurrence (ROR) score on late distant recurrence (beyond 5 years after diagnosis and treatment) in a large cohort of postmenopausal, endocrine-responsive breast cancer patients.
  
  
  METHODS
  The PAM50 assay was performed on formalin-fixed paraffin-embedded whole-tumor sections of patients who had been enrolled in the Austrian Breast and Colorectal Cancer Study Group Trial 8 (ABCSG-8). RNA expression levels of the PAM50 genes were determined centrally using the nCounter Dx Analysis System. Late distant recurrence-free survival (DRFS) was analyzed using Cox models adjusted for clinical and pathologic parameters.
  
  
  RESULTS
  PAM50 analysis was successfully performed in 1,246 ABCSG-8 patients. PAM50 ROR score and ROR-based risk groups provided significant additional prognostic information with respect to late DRFS compared with a combined score of clinical factors alone (ROR score: ΔLRχ(2) 15.32, P < 0.001; ROR-based risk groups: ΔLRχ(2) 14.83, P < 0.001). Between years 5 and 15, we observed an absolute risk of distant recurrence of 2.4% in the low ROR-based risk group, as compared with 17.5% in the high ROR-based risk group. The DRFS differences according to the PAM50 ROR score were observed for both node-positive and node-negative disease.
  
  
  CONCLUSIONS
  PAM50 ROR score and ROR-based risk groups can differentiate patients with breast cancer with respect to their risk for late distant recurrence beyond what can be achieved with established clinicopathologic risk factors.
authors: Authors' Affiliations: Departments of Medicine I, Pathology, and Surgery; Department of Obstetrics and Gynecology, Comprehensive Cancer Center Vienna, Medical University of Vienna; Austrian Breast and Colorectal Cancer Study Group, Vienna; Departments of Internal Medicine III and Pathology, Paracelsus Private Medical University, Salzburg; Departments of Internal Medicine and Pathology, Medical University of Graz, Graz; Departments of Pathology and Surgery, Sisters of Charity Hospital and Cancer Center, Linz; Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck; Department of Surgery, General Hospital Baden, Baden, Austria; Myraqa, Redwood Shores, California; NanoString Technologies, Seattle, Washington; and British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors: Martin
authors: M
authors: Filipits
authors: Torsten O
authors: TO
authors: Nielsen
authors: Margaretha
authors: M
authors: Rudas
authors: Richard
authors: R
authors: Greil
authors: Herbert
authors: H
authors: Stöger
authors: Raimund
authors: R
authors: Jakesz
authors: Zsuzsanna
authors: Z
authors: Bago-Horvath
authors: Otto
authors: O
authors: Dietze
authors: Peter
authors: P
authors: Regitnig
authors: Christine
authors: C
authors: Gruber-Rossipal
authors: Elisabeth
authors: E
authors: Müller-Holzner
authors: Christian F
authors: CF
authors: Singer
authors: Brigitte
authors: B
authors: Mlineritsch
authors: Peter
authors: P
authors: Dubsky
authors: Thomas
authors: T
authors: Bauernhofer
authors: Michael
authors: M
authors: Hubalek
authors: Michael
authors: M
authors: Knauer
authors: Harald
authors: H
authors: Trapl
authors: Christian
authors: C
authors: Fesl
authors: Carl
authors: C
authors: Schaper
authors: Sean
authors: S
authors: Ferree
authors: Shuzhen
authors: S
authors: Liu
authors: J Wayne
authors: JW
authors: Cowens
authors: Michael
authors: M
authors: Gnant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D020869:Gene Expression Profiling; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D017698:Postmenopause; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal