Clinical validation of an immunohistochemistry‐based CanAssist‐Breast test for distant recurrence prediction in hormone receptor‐positive breast cancer patients

CanAssist‐Breast (CAB) is an immunohistochemistry (IHC)‐based prognostic test for early‐stage Hormone Receptor (HR+)‐positive breast cancer patients. CAB uses a Support Vector Machine (SVM) trained algorithm which utilizes expression levels of five biomarkers (CD44, ABCC4, ABCC11, N‐Cadherin, and Pa...

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Published in:Cancer medicine (Malden, MA) MA), 2019-04, Vol.8 (4), p.1755-1764
Main Authors: Bakre, Manjiri M., Ramkumar, Charusheila, Attuluri, Arun Kumar, Basavaraj, Chetana, Prakash, Chandra, Buturovic, Ljubomir, Madhav, Lekshmi, Naidu, Nirupama, R, Prathima, Somashekhar, S. P., Gupta, Sudeep, Doval, Dinesh Chandra, Pegram, Mark D.
Format: Article
Language:English
Subjects:
Adult
Aged
Algorithms
Biology
Biomarkers
Biomarkers, Tumor - metabolism
Breast cancer
Breast Neoplasms - diagnosis
Breast Neoplasms - pathology
Breast Neoplasms - therapy
Cadherins
CanAssist‐Breast
Cancer Biology
Cancer therapies
CD44 antigen
Cell adhesion & migration
Chemotherapy
distant recurrence
Drug resistance
early‐stage breast cancer
Endocrine therapy
Ethics
Female
Humans
Immunohistochemistry
Kaplan-Meier Estimate
Laboratories
Localization
Lymphatic Metastasis
Medical prognosis
Metastases
Metastasis
Middle Aged
Multivariate analysis
Neoplasm Grading
Neoplasm Metastasis
Neoplasm Staging
Original Research
Patients
Prognosis
prognostication
Receptors, Estrogen - metabolism
Receptors, Progesterone - metabolism
Retrospective Studies
Risk Assessment - methods
Support Vector Machine
Survival
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Summary:CanAssist‐Breast (CAB) is an immunohistochemistry (IHC)‐based prognostic test for early‐stage Hormone Receptor (HR+)‐positive breast cancer patients. CAB uses a Support Vector Machine (SVM) trained algorithm which utilizes expression levels of five biomarkers (CD44, ABCC4, ABCC11, N‐Cadherin, and Pan‐Cadherin) and three clinical parameters such as tumor size, grade, and node status as inputs to generate a risk score and categorizes patients as low‐ or high‐risk for distant recurrence within 5 years of diagnosis. In this study, we present clinical validation of CAB. CAB was validated using a retrospective cohort of 857 patients. All patients were treated either with endocrine therapy or chemoendocrine therapy. Risk categorization by CAB was analyzed by calculating Distant Metastasis‐Free Survival (DMFS) and recurrence rates using Kaplan‐Meier survival curves. Multivariate analysis was performed to calculate Hazard ratios (HR) for CAB high‐risk vs low‐risk patients. The results showed that Distant Metastasis‐Free Survival (DMFS) was significantly different (P‐0.002) between low‐ (DMFS: 95%) and high‐risk (DMFS: 80%) categories in the endocrine therapy treated alone subgroup (n = 195) as well as in the total cohort (n = 857, low‐risk DMFS: 95%, high‐risk DMFS: 84%, P 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.2049