Prognostic model for advanced breast carcinoma with luminal subtype and impact of hormonal maintenance: Implications for post-progression and conditional survival

Luisa Carbognin, Isabella Sperduti, Mariangela Ciccarese, Alessandra Fabi, Luciana Petrucelli, Sabrina Vari, Rosa Chiara Forcignanò, Rolando Nortilli, Cecilia Vicentini, Sara Pilotto, Sara Merler, Ilaria Zampiva, Matteo Brunelli, Erminia Manfrin, Diana Giannarelli, Giampaolo Tortora, Emilio Bria

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The aim of this analysis was to develop and validate a prognostic model for advanced breast cancer (ABC) with luminal subtype based on the combination of clinical, pathological and therapeutic predictors to provide a practical tool to evaluate patients' prognosis. Methods: Clinical and pathological data were retrospectively correlated to progression-free and overall survival (PFS/OS) using a Cox model. Significant treatment variables were adjusted with the propensity score analysis. A continuous score to identify risk classes was derived according to model ratios. The performance of the risk-class model was tested for post-progression survival (PPS) and conditional survival (CS) as well. Results: Data from 335 patients (3 institutions) were gathered (median follow-up 58 months). At multivariate analysis Ki67, Performance Status (PS) and number of metastatic sites were significant predictors for PFS, whereas Ki67, PS, brain metastases, PFS after 1st-line therapy, number of chemotherapy lines, hormonal therapy and maintenance were significant predictors for OS. The hormonal maintenance resulted to be prognostic after adjustment with propensity score analysis. A two-class model significantly differentiated low-risk and high-risk patients for 2-year PFS (31.5% and 11.0%, p <0.0001), and 3-years OS (57.1% and 4.8%, p <0.0001). A three-class model separated low risk, intermediate-risk, and high-risk patients for 2-year PFS (40.8%, 24.4%, and 11.0%, p <0.0001) and 3-year OS (68.1%, 24.8%, and 4.8%, p <0.0001). Both models equally discriminate the luminal ABC prognosis in terms of PPS and CS. Conclusions: A risk stratification model including 'easy-to-obtain' clinical, pathological and therapeutic parameters accurately separates luminal ABC patients into different risk classes.

Original languageEnglish
Pages (from-to)24-30
Number of pages7
JournalBreast
Volume29
DOIs
Publication statusPublished - Oct 1 2016

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Maintenance
Breast Neoplasms
Survival
Propensity Score
Therapeutics
Proportional Hazards Models
Disease-Free Survival
Multivariate Analysis
Neoplasm Metastasis
Drug Therapy
Brain

Keywords

  • Advanced breast
  • Breast cancer
  • Luminal
  • Prognosis

ASJC Scopus subject areas

  • Surgery

Cite this

Prognostic model for advanced breast carcinoma with luminal subtype and impact of hormonal maintenance : Implications for post-progression and conditional survival. / Carbognin, Luisa; Sperduti, Isabella; Ciccarese, Mariangela; Fabi, Alessandra; Petrucelli, Luciana; Vari, Sabrina; Forcignanò, Rosa Chiara; Nortilli, Rolando; Vicentini, Cecilia; Pilotto, Sara; Merler, Sara; Zampiva, Ilaria; Brunelli, Matteo; Manfrin, Erminia; Giannarelli, Diana; Tortora, Giampaolo; Bria, Emilio.

In: Breast, Vol. 29, 01.10.2016, p. 24-30.

Research output: Contribution to journalArticle

Carbognin, L, Sperduti, I, Ciccarese, M, Fabi, A, Petrucelli, L, Vari, S, Forcignanò, RC, Nortilli, R, Vicentini, C, Pilotto, S, Merler, S, Zampiva, I, Brunelli, M, Manfrin, E, Giannarelli, D, Tortora, G & Bria, E 2016, 'Prognostic model for advanced breast carcinoma with luminal subtype and impact of hormonal maintenance: Implications for post-progression and conditional survival', Breast, vol. 29, pp. 24-30. https://doi.org/10.1016/j.breast.2016.06.021
Carbognin, Luisa ; Sperduti, Isabella ; Ciccarese, Mariangela ; Fabi, Alessandra ; Petrucelli, Luciana ; Vari, Sabrina ; Forcignanò, Rosa Chiara ; Nortilli, Rolando ; Vicentini, Cecilia ; Pilotto, Sara ; Merler, Sara ; Zampiva, Ilaria ; Brunelli, Matteo ; Manfrin, Erminia ; Giannarelli, Diana ; Tortora, Giampaolo ; Bria, Emilio. / Prognostic model for advanced breast carcinoma with luminal subtype and impact of hormonal maintenance : Implications for post-progression and conditional survival. In: Breast. 2016 ; Vol. 29. pp. 24-30.
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abstract = "Background: The aim of this analysis was to develop and validate a prognostic model for advanced breast cancer (ABC) with luminal subtype based on the combination of clinical, pathological and therapeutic predictors to provide a practical tool to evaluate patients' prognosis. Methods: Clinical and pathological data were retrospectively correlated to progression-free and overall survival (PFS/OS) using a Cox model. Significant treatment variables were adjusted with the propensity score analysis. A continuous score to identify risk classes was derived according to model ratios. The performance of the risk-class model was tested for post-progression survival (PPS) and conditional survival (CS) as well. Results: Data from 335 patients (3 institutions) were gathered (median follow-up 58 months). At multivariate analysis Ki67, Performance Status (PS) and number of metastatic sites were significant predictors for PFS, whereas Ki67, PS, brain metastases, PFS after 1st-line therapy, number of chemotherapy lines, hormonal therapy and maintenance were significant predictors for OS. The hormonal maintenance resulted to be prognostic after adjustment with propensity score analysis. A two-class model significantly differentiated low-risk and high-risk patients for 2-year PFS (31.5{\%} and 11.0{\%}, p <0.0001), and 3-years OS (57.1{\%} and 4.8{\%}, p <0.0001). A three-class model separated low risk, intermediate-risk, and high-risk patients for 2-year PFS (40.8{\%}, 24.4{\%}, and 11.0{\%}, p <0.0001) and 3-year OS (68.1{\%}, 24.8{\%}, and 4.8{\%}, p <0.0001). Both models equally discriminate the luminal ABC prognosis in terms of PPS and CS. Conclusions: A risk stratification model including 'easy-to-obtain' clinical, pathological and therapeutic parameters accurately separates luminal ABC patients into different risk classes.",
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T1 - Prognostic model for advanced breast carcinoma with luminal subtype and impact of hormonal maintenance

T2 - Implications for post-progression and conditional survival

AU - Carbognin, Luisa

AU - Sperduti, Isabella

AU - Ciccarese, Mariangela

AU - Fabi, Alessandra

AU - Petrucelli, Luciana

AU - Vari, Sabrina

AU - Forcignanò, Rosa Chiara

AU - Nortilli, Rolando

AU - Vicentini, Cecilia

AU - Pilotto, Sara

AU - Merler, Sara

AU - Zampiva, Ilaria

AU - Brunelli, Matteo

AU - Manfrin, Erminia

AU - Giannarelli, Diana

AU - Tortora, Giampaolo

AU - Bria, Emilio

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background: The aim of this analysis was to develop and validate a prognostic model for advanced breast cancer (ABC) with luminal subtype based on the combination of clinical, pathological and therapeutic predictors to provide a practical tool to evaluate patients' prognosis. Methods: Clinical and pathological data were retrospectively correlated to progression-free and overall survival (PFS/OS) using a Cox model. Significant treatment variables were adjusted with the propensity score analysis. A continuous score to identify risk classes was derived according to model ratios. The performance of the risk-class model was tested for post-progression survival (PPS) and conditional survival (CS) as well. Results: Data from 335 patients (3 institutions) were gathered (median follow-up 58 months). At multivariate analysis Ki67, Performance Status (PS) and number of metastatic sites were significant predictors for PFS, whereas Ki67, PS, brain metastases, PFS after 1st-line therapy, number of chemotherapy lines, hormonal therapy and maintenance were significant predictors for OS. The hormonal maintenance resulted to be prognostic after adjustment with propensity score analysis. A two-class model significantly differentiated low-risk and high-risk patients for 2-year PFS (31.5% and 11.0%, p <0.0001), and 3-years OS (57.1% and 4.8%, p <0.0001). A three-class model separated low risk, intermediate-risk, and high-risk patients for 2-year PFS (40.8%, 24.4%, and 11.0%, p <0.0001) and 3-year OS (68.1%, 24.8%, and 4.8%, p <0.0001). Both models equally discriminate the luminal ABC prognosis in terms of PPS and CS. Conclusions: A risk stratification model including 'easy-to-obtain' clinical, pathological and therapeutic parameters accurately separates luminal ABC patients into different risk classes.

AB - Background: The aim of this analysis was to develop and validate a prognostic model for advanced breast cancer (ABC) with luminal subtype based on the combination of clinical, pathological and therapeutic predictors to provide a practical tool to evaluate patients' prognosis. Methods: Clinical and pathological data were retrospectively correlated to progression-free and overall survival (PFS/OS) using a Cox model. Significant treatment variables were adjusted with the propensity score analysis. A continuous score to identify risk classes was derived according to model ratios. The performance of the risk-class model was tested for post-progression survival (PPS) and conditional survival (CS) as well. Results: Data from 335 patients (3 institutions) were gathered (median follow-up 58 months). At multivariate analysis Ki67, Performance Status (PS) and number of metastatic sites were significant predictors for PFS, whereas Ki67, PS, brain metastases, PFS after 1st-line therapy, number of chemotherapy lines, hormonal therapy and maintenance were significant predictors for OS. The hormonal maintenance resulted to be prognostic after adjustment with propensity score analysis. A two-class model significantly differentiated low-risk and high-risk patients for 2-year PFS (31.5% and 11.0%, p <0.0001), and 3-years OS (57.1% and 4.8%, p <0.0001). A three-class model separated low risk, intermediate-risk, and high-risk patients for 2-year PFS (40.8%, 24.4%, and 11.0%, p <0.0001) and 3-year OS (68.1%, 24.8%, and 4.8%, p <0.0001). Both models equally discriminate the luminal ABC prognosis in terms of PPS and CS. Conclusions: A risk stratification model including 'easy-to-obtain' clinical, pathological and therapeutic parameters accurately separates luminal ABC patients into different risk classes.

KW - Advanced breast

KW - Breast cancer

KW - Luminal

KW - Prognosis

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