Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial: No Test Is More Equal Than the Others

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Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial : No Test Is More Equal Than the Others. / Bartlett, John M S; Bayani, Jane; Marshall, Andrea; Dunn, Janet A; Campbell, Amy; Cunningham, Carrie; Sobol, Monika S; Hall, Peter S; Poole, Christopher J; Cameron, David A; Earl, Helena M; Rea, Daniel W; Macpherson, Iain R; Canney, Peter; Francis, Adele; McCabe, Christopher; Pinder, Sarah E; Hughes-Davies, Luke; Makris, Andreas; Stein, Robert C; OPTIMA Trial Management Group.

In: Journal of the National Cancer Institute, Vol. 108, No. 9, 09.2016.

Research output: Contribution to journalArticle

Harvard

Bartlett, JMS, Bayani, J, Marshall, A, Dunn, JA, Campbell, A, Cunningham, C, Sobol, MS, Hall, PS, Poole, CJ, Cameron, DA, Earl, HM, Rea, DW, Macpherson, IR, Canney, P, Francis, A, McCabe, C, Pinder, SE, Hughes-Davies, L, Makris, A, Stein, RC & OPTIMA Trial Management Group 2016, 'Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial: No Test Is More Equal Than the Others', Journal of the National Cancer Institute, vol. 108, no. 9. https://doi.org/10.1093/jnci/djw050

APA

Bartlett, J. M. S., Bayani, J., Marshall, A., Dunn, J. A., Campbell, A., Cunningham, C., Sobol, M. S., Hall, P. S., Poole, C. J., Cameron, D. A., Earl, H. M., Rea, D. W., Macpherson, I. R., Canney, P., Francis, A., McCabe, C., Pinder, S. E., Hughes-Davies, L., Makris, A., ... OPTIMA Trial Management Group (2016). Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial: No Test Is More Equal Than the Others. Journal of the National Cancer Institute, 108(9). https://doi.org/10.1093/jnci/djw050

Vancouver

Author

Bartlett, John M S ; Bayani, Jane ; Marshall, Andrea ; Dunn, Janet A ; Campbell, Amy ; Cunningham, Carrie ; Sobol, Monika S ; Hall, Peter S ; Poole, Christopher J ; Cameron, David A ; Earl, Helena M ; Rea, Daniel W ; Macpherson, Iain R ; Canney, Peter ; Francis, Adele ; McCabe, Christopher ; Pinder, Sarah E ; Hughes-Davies, Luke ; Makris, Andreas ; Stein, Robert C ; OPTIMA Trial Management Group. / Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial : No Test Is More Equal Than the Others. In: Journal of the National Cancer Institute. 2016 ; Vol. 108, No. 9.

Bibtex

@article{07ed184266544c288b49cc3e92216b09,
title = "Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial: No Test Is More Equal Than the Others",
abstract = "BACKGROUND: Previous reports identifying discordance between multiparameter tests at the individual patient level have been largely attributed to methodological shortcomings of multiple in silico studies. Comparisons between tests, when performed using actual diagnostic assays, have been predicted to demonstrate high degrees of concordance. OPTIMA prelim compared predicted risk stratification and subtype classification of different multiparameter tests performed directly on the same population.METHODS: Three hundred thirteen women with early breast cancer were randomized to standard (chemotherapy and endocrine therapy) or test-directed (chemotherapy if Oncotype DX recurrence score >25) treatment. Risk stratification was also determined with Prosigna (PAM50), MammaPrint, MammaTyper, NexCourse Breast (IHC4-AQUA), and conventional IHC4 (IHC4). Subtype classification was provided by Blueprint, MammaTyper, and Prosigna.RESULTS: Oncotype DX predicted a higher proportion of tumors as low risk (82.1%, 95% confidence interval [CI] = 77.8% to 86.4%) than were predicted low/intermediate risk using Prosigna (65.5%, 95% CI = 60.1% to 70.9%), IHC4 (72.0%, 95% CI = 66.5% to 77.5%), MammaPrint (61.4%, 95% CI = 55.9% to 66.9%), or NexCourse Breast (61.6%, 95% CI = 55.8% to 67.4%). Strikingly, the five tests showed only modest agreement when dichotomizing results between high vs low/intermediate risk. Only 119 (39.4%) tumors were classified uniformly as either low/intermediate risk or high risk, and 183 (60.6%) were assigned to different risk categories by different tests, although 94 (31.1%) showed agreement between four of five tests. All three subtype tests assigned 59.5% to 62.4% of tumors to luminal A subtype, but only 121 (40.1%) were classified as luminal A by all three tests and only 58 (19.2%) were uniformly assigned as nonluminal A. Discordant subtyping was observed in 123 (40.7%) tumors.CONCLUSIONS: Existing evidence on the comparative prognostic information provided by different tests suggests that current multiparameter tests provide broadly equivalent risk information for the population of women with estrogen receptor (ER)-positive breast cancers. However, for the individual patient, tests may provide differing risk categorization and subtype information.",
author = "Bartlett, {John M S} and Jane Bayani and Andrea Marshall and Dunn, {Janet A} and Amy Campbell and Carrie Cunningham and Sobol, {Monika S} and Hall, {Peter S} and Poole, {Christopher J} and Cameron, {David A} and Earl, {Helena M} and Rea, {Daniel W} and Macpherson, {Iain R} and Peter Canney and Adele Francis and Christopher McCabe and Pinder, {Sarah E} and Luke Hughes-Davies and Andreas Makris and Stein, {Robert C} and {OPTIMA Trial Management Group}",
note = "{\textcopyright} The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
year = "2016",
month = sep
doi = "10.1093/jnci/djw050",
language = "English",
volume = "108",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "9",

}

RIS

TY - JOUR

T1 - Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial

T2 - No Test Is More Equal Than the Others

AU - Bartlett, John M S

AU - Bayani, Jane

AU - Marshall, Andrea

AU - Dunn, Janet A

AU - Campbell, Amy

AU - Cunningham, Carrie

AU - Sobol, Monika S

AU - Hall, Peter S

AU - Poole, Christopher J

AU - Cameron, David A

AU - Earl, Helena M

AU - Rea, Daniel W

AU - Macpherson, Iain R

AU - Canney, Peter

AU - Francis, Adele

AU - McCabe, Christopher

AU - Pinder, Sarah E

AU - Hughes-Davies, Luke

AU - Makris, Andreas

AU - Stein, Robert C

AU - OPTIMA Trial Management Group

N1 - © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2016/9

Y1 - 2016/9

N2 - BACKGROUND: Previous reports identifying discordance between multiparameter tests at the individual patient level have been largely attributed to methodological shortcomings of multiple in silico studies. Comparisons between tests, when performed using actual diagnostic assays, have been predicted to demonstrate high degrees of concordance. OPTIMA prelim compared predicted risk stratification and subtype classification of different multiparameter tests performed directly on the same population.METHODS: Three hundred thirteen women with early breast cancer were randomized to standard (chemotherapy and endocrine therapy) or test-directed (chemotherapy if Oncotype DX recurrence score >25) treatment. Risk stratification was also determined with Prosigna (PAM50), MammaPrint, MammaTyper, NexCourse Breast (IHC4-AQUA), and conventional IHC4 (IHC4). Subtype classification was provided by Blueprint, MammaTyper, and Prosigna.RESULTS: Oncotype DX predicted a higher proportion of tumors as low risk (82.1%, 95% confidence interval [CI] = 77.8% to 86.4%) than were predicted low/intermediate risk using Prosigna (65.5%, 95% CI = 60.1% to 70.9%), IHC4 (72.0%, 95% CI = 66.5% to 77.5%), MammaPrint (61.4%, 95% CI = 55.9% to 66.9%), or NexCourse Breast (61.6%, 95% CI = 55.8% to 67.4%). Strikingly, the five tests showed only modest agreement when dichotomizing results between high vs low/intermediate risk. Only 119 (39.4%) tumors were classified uniformly as either low/intermediate risk or high risk, and 183 (60.6%) were assigned to different risk categories by different tests, although 94 (31.1%) showed agreement between four of five tests. All three subtype tests assigned 59.5% to 62.4% of tumors to luminal A subtype, but only 121 (40.1%) were classified as luminal A by all three tests and only 58 (19.2%) were uniformly assigned as nonluminal A. Discordant subtyping was observed in 123 (40.7%) tumors.CONCLUSIONS: Existing evidence on the comparative prognostic information provided by different tests suggests that current multiparameter tests provide broadly equivalent risk information for the population of women with estrogen receptor (ER)-positive breast cancers. However, for the individual patient, tests may provide differing risk categorization and subtype information.

AB - BACKGROUND: Previous reports identifying discordance between multiparameter tests at the individual patient level have been largely attributed to methodological shortcomings of multiple in silico studies. Comparisons between tests, when performed using actual diagnostic assays, have been predicted to demonstrate high degrees of concordance. OPTIMA prelim compared predicted risk stratification and subtype classification of different multiparameter tests performed directly on the same population.METHODS: Three hundred thirteen women with early breast cancer were randomized to standard (chemotherapy and endocrine therapy) or test-directed (chemotherapy if Oncotype DX recurrence score >25) treatment. Risk stratification was also determined with Prosigna (PAM50), MammaPrint, MammaTyper, NexCourse Breast (IHC4-AQUA), and conventional IHC4 (IHC4). Subtype classification was provided by Blueprint, MammaTyper, and Prosigna.RESULTS: Oncotype DX predicted a higher proportion of tumors as low risk (82.1%, 95% confidence interval [CI] = 77.8% to 86.4%) than were predicted low/intermediate risk using Prosigna (65.5%, 95% CI = 60.1% to 70.9%), IHC4 (72.0%, 95% CI = 66.5% to 77.5%), MammaPrint (61.4%, 95% CI = 55.9% to 66.9%), or NexCourse Breast (61.6%, 95% CI = 55.8% to 67.4%). Strikingly, the five tests showed only modest agreement when dichotomizing results between high vs low/intermediate risk. Only 119 (39.4%) tumors were classified uniformly as either low/intermediate risk or high risk, and 183 (60.6%) were assigned to different risk categories by different tests, although 94 (31.1%) showed agreement between four of five tests. All three subtype tests assigned 59.5% to 62.4% of tumors to luminal A subtype, but only 121 (40.1%) were classified as luminal A by all three tests and only 58 (19.2%) were uniformly assigned as nonluminal A. Discordant subtyping was observed in 123 (40.7%) tumors.CONCLUSIONS: Existing evidence on the comparative prognostic information provided by different tests suggests that current multiparameter tests provide broadly equivalent risk information for the population of women with estrogen receptor (ER)-positive breast cancers. However, for the individual patient, tests may provide differing risk categorization and subtype information.

U2 - 10.1093/jnci/djw050

DO - 10.1093/jnci/djw050

M3 - Article

C2 - 27130929

VL - 108

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 9

ER -