Nomogram for the personalisation of radiotherapy treatments in breast cancer patients

Breast. 2021 Dec:60:255-262. doi: 10.1016/j.breast.2021.11.004. Epub 2021 Nov 9.

Abstract

Introduction: Numerous prospective studies have shown that the incorporation of genomic assays into clinical practice significantly impacts the choice of adjuvant treatments for patients with early-stage breast cancer. However, the same evidence does not exist for the treatment of locoregional recurrences.

Hypothesis and objectives: The main objective of this work was to identify the clinicopathological, molecular, and genetic parameters that allow patients to be more precisely categorised into risk groups, in order to create a locoregional recurrence riskclassification tool, the PersonalRT27.

Material and methods: To create PersonalRT27, we retrospective assessed the variables of patients with early breast cancer (stages I or II) who had undergone the OncotypeDx ® and MammaPrint ® genetic tests. These variables and factors included in the tests were categorised and weighted to obtain scores between 1 and 5 pointsto represent a lower or higher risk of relapse, respectively, based on these factors and as determined by the researchers.

Results: The mean follow-up time was 60.5 months (range 25-96 months); locoregional progression-free survival at the time of the analysis was 98.4%, and overall survival was 97.5%, of which 0.6% of the deaths had been cancer specific. The area under the curve for the PersonalRT27 was 0.76 (95% CI [0.70, 0.81]), sensitivity was 78%, and the specificity was 58.9%. We used these factors to create an inhospital web-based nomogram.

Conclusions: The PersonalRT27 is a novel tool that integrates clinical-pathological, molecular, and genetic parameters. External and independent validation will be required to implement its clinical use.

Keywords: Breast cancer; Cáncer de mama; Genetic assays; Local relapse; Plataformas genómicas; Radioterapia; Radiotherapy; Recaída local.

MeSH terms

  • Breast Neoplasms* / genetics
  • Breast Neoplasms* / radiotherapy
  • Female
  • Humans
  • Neoplasm Recurrence, Local / genetics
  • Nomograms
  • Prospective Studies
  • Radiotherapy, Adjuvant
  • Retrospective Studies