Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer.
We validated an 18-gene classifier (GC) initially developed to predict local/regional recurrence after mastectomy in estimating distant metastasis risk. The 18-gene scoring algorithm defines scores as: <21, low risk; ≥21, high risk. Six hundred eighty-three patients with primary operable breast c...
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184372&type=printable |
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| author | Skye Hung-Chun Cheng Tzu-Ting Huang Yu-Hao Cheng Tee Benita Kiat Tan Chen-Fang Horng Yong Alison Wang Nicholas Shannon Brian Li-Sun Shih Ben-Long Yu |
| author_facet | Skye Hung-Chun Cheng Tzu-Ting Huang Yu-Hao Cheng Tee Benita Kiat Tan Chen-Fang Horng Yong Alison Wang Nicholas Shannon Brian Li-Sun Shih Ben-Long Yu |
| author_sort | Skye Hung-Chun Cheng |
| collection | DOAJ |
| description | We validated an 18-gene classifier (GC) initially developed to predict local/regional recurrence after mastectomy in estimating distant metastasis risk. The 18-gene scoring algorithm defines scores as: <21, low risk; ≥21, high risk. Six hundred eighty-three patients with primary operable breast cancer and fresh frozen tumor tissues available were included. The primary outcome was the 5-year probability of freedom from distant metastasis (DMFP). Two external datasets were used to test the predictive accuracy of 18-GC. The 5-year rates of DMFP for patients classified as low-risk (n = 146, 21.7%) and high-risk (n = 537, 78.6%) were 96.2% (95% CI, 91.1%-98.8%) and 80.9% (74.6%-81.9%), respectively (median follow-up interval, 71.8 months). The 5-year rates of DMFP of the low-risk group in stage I (n = 62, 35.6%), stage II (n = 66, 20.1%), and stage III (n = 18, 10.3%) were 100%, 94.2% (78.5%-98.5%), and 90.9% (50.8%-98.7%), respectively. Multivariate analysis revealed that 18-GC is an independent prognostic factor of distant metastasis (adjusted hazard ratio, 5.1; 95% CI, 1.8-14.1; p = 0.0017) for scores of ≥21. External validation showed that the 5-year rate of DMFP in the low- and high-risk patients was 94.1% (82.9%-100%) and 80.3% (70.7%-89.9%, p = 0.06) in a Singapore dataset, and 89.5% (81.9%-94.1%) and 73.6% (67.2%-79.0%, p = 0.0039) in the GEO-GSE20685 dataset, respectively. In conclusion, 18-GC is a viable prognostic biomarker for breast cancer to estimate distant metastasis risk. |
| format | Article |
| id | doaj-art-0ac2e774c5b8482589ee63fe4e9861cb |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-0ac2e774c5b8482589ee63fe4e9861cb2025-08-20T02:03:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01129e018437210.1371/journal.pone.0184372Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer.Skye Hung-Chun ChengTzu-Ting HuangYu-Hao ChengTee Benita Kiat TanChen-Fang HorngYong Alison WangNicholas Shannon BrianLi-Sun ShihBen-Long YuWe validated an 18-gene classifier (GC) initially developed to predict local/regional recurrence after mastectomy in estimating distant metastasis risk. The 18-gene scoring algorithm defines scores as: <21, low risk; ≥21, high risk. Six hundred eighty-three patients with primary operable breast cancer and fresh frozen tumor tissues available were included. The primary outcome was the 5-year probability of freedom from distant metastasis (DMFP). Two external datasets were used to test the predictive accuracy of 18-GC. The 5-year rates of DMFP for patients classified as low-risk (n = 146, 21.7%) and high-risk (n = 537, 78.6%) were 96.2% (95% CI, 91.1%-98.8%) and 80.9% (74.6%-81.9%), respectively (median follow-up interval, 71.8 months). The 5-year rates of DMFP of the low-risk group in stage I (n = 62, 35.6%), stage II (n = 66, 20.1%), and stage III (n = 18, 10.3%) were 100%, 94.2% (78.5%-98.5%), and 90.9% (50.8%-98.7%), respectively. Multivariate analysis revealed that 18-GC is an independent prognostic factor of distant metastasis (adjusted hazard ratio, 5.1; 95% CI, 1.8-14.1; p = 0.0017) for scores of ≥21. External validation showed that the 5-year rate of DMFP in the low- and high-risk patients was 94.1% (82.9%-100%) and 80.3% (70.7%-89.9%, p = 0.06) in a Singapore dataset, and 89.5% (81.9%-94.1%) and 73.6% (67.2%-79.0%, p = 0.0039) in the GEO-GSE20685 dataset, respectively. In conclusion, 18-GC is a viable prognostic biomarker for breast cancer to estimate distant metastasis risk.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184372&type=printable |
| spellingShingle | Skye Hung-Chun Cheng Tzu-Ting Huang Yu-Hao Cheng Tee Benita Kiat Tan Chen-Fang Horng Yong Alison Wang Nicholas Shannon Brian Li-Sun Shih Ben-Long Yu Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer. PLoS ONE |
| title | Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer. |
| title_full | Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer. |
| title_fullStr | Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer. |
| title_full_unstemmed | Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer. |
| title_short | Validation of the 18-gene classifier as a prognostic biomarker of distant metastasis in breast cancer. |
| title_sort | validation of the 18 gene classifier as a prognostic biomarker of distant metastasis in breast cancer |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184372&type=printable |
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