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Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer

Anita M. Huws Orcid Logo, Gareth R. Davies, Paul Lewis, Claire Morgan Orcid Logo

Clinical Breast Cancer

Swansea University Authors: Paul Lewis, Claire Morgan Orcid Logo

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DOI (Published version): 10.1016/j.clbc.2024.11.022

Abstract

Background: Adjuvant therapy decisions in hormone receptor positive and human epidermal growth factor receptor 2 negative breast cancer are evolving. The introduction of gene panel testing has significantly reduced the number of patients recommended for chemotherapy by up to two thirds. However, the...

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Published in: Clinical Breast Cancer
ISSN: 1526-8209 1938-0666
Published: Elsevier BV 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa68516
first_indexed 2024-12-10T20:11:31Z
last_indexed 2025-04-17T04:44:17Z
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The introduction of gene panel testing has significantly reduced the number of patients recommended for chemotherapy by up to two thirds. However, these tests are expensive, highlighting the need to identify low-risk genomic breast cancer cases before testing, which could represent a significant economic impact. The use of systemic inflammatory indices has shown promise as prognostic markers in early breast cancer. We investigated the potential utility of four systemic inflammatory indices with the Nottingham Prognostic Index to predict the Oncotype DX&#xAE; recurrence scores threshold level (low score or high score), in a cohort of women aged 50 and over with node negative invasive ductal carcinoma of the breast. Methods: A retrospective review of patients who had Oncotype DX&#xAE; Recurrence Score testing from 2007 to 2021 were identified. After exclusions, the final sample size was 245. Clinicopathological features were collected to calculate the Nottingham Prognostic Index. The systemic inflammatory indices were estimated from preoperative peripheral blood samples. Results: 22.4% of the cohort had a Recurrence Score in the higher risk group. This cohort had a greater percentage of grade 3 tumours, progesterone receptor negativity, higher Nottingham Prognostic Scores, and inflammatory indices ratios than the lower risk group. A decision tree incorporating the Neutrophil Lymphocyte Ratio with clinicopathological features showed potential as an indicator of a high Oncotype DX&#xAE; RS score, such that further investigation is warranted to assess whether Recurrence Score testing could be triaged in certain cohorts of patients. In this cohort, 38% of patients might be able to avoid genomic testing based on the decision tree analysis. 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spelling 2025-04-16T13:39:26.6034786 v2 68516 2024-12-10 Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer 46dfc22d7468f247c390ba0c6cd8fba6 Paul Lewis Paul Lewis true false 52c886f26c1b4d9d817000ac6e58a486 0000-0002-3969-0710 Claire Morgan Claire Morgan true false 2024-12-10 CBAE Background: Adjuvant therapy decisions in hormone receptor positive and human epidermal growth factor receptor 2 negative breast cancer are evolving. The introduction of gene panel testing has significantly reduced the number of patients recommended for chemotherapy by up to two thirds. However, these tests are expensive, highlighting the need to identify low-risk genomic breast cancer cases before testing, which could represent a significant economic impact. The use of systemic inflammatory indices has shown promise as prognostic markers in early breast cancer. We investigated the potential utility of four systemic inflammatory indices with the Nottingham Prognostic Index to predict the Oncotype DX® recurrence scores threshold level (low score or high score), in a cohort of women aged 50 and over with node negative invasive ductal carcinoma of the breast. Methods: A retrospective review of patients who had Oncotype DX® Recurrence Score testing from 2007 to 2021 were identified. After exclusions, the final sample size was 245. Clinicopathological features were collected to calculate the Nottingham Prognostic Index. The systemic inflammatory indices were estimated from preoperative peripheral blood samples. Results: 22.4% of the cohort had a Recurrence Score in the higher risk group. This cohort had a greater percentage of grade 3 tumours, progesterone receptor negativity, higher Nottingham Prognostic Scores, and inflammatory indices ratios than the lower risk group. A decision tree incorporating the Neutrophil Lymphocyte Ratio with clinicopathological features showed potential as an indicator of a high Oncotype DX® RS score, such that further investigation is warranted to assess whether Recurrence Score testing could be triaged in certain cohorts of patients. In this cohort, 38% of patients might be able to avoid genomic testing based on the decision tree analysis. Conclusion: Utility of the inflammatory indices with clinicopathological features may help triage gene panel testing. Journal Article Clinical Breast Cancer 0 Elsevier BV 1526-8209 1938-0666 Early Breast Cancer; Adjuvant; Peripheral Blood Inflammatory Markers; Oncotype DX; NPI 7 12 2024 2024-12-07 10.1016/j.clbc.2024.11.022 COLLEGE NANME Management School COLLEGE CODE CBAE Swansea University Not Required No funding was received for the study. 2025-04-16T13:39:26.6034786 2024-12-10T11:56:46.4870219 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science Anita M. Huws 0000-0002-0887-8964 1 Gareth R. Davies 2 Paul Lewis 3 Claire Morgan 0000-0002-3969-0710 4 68516__33193__7dafa200a88246b5bb199a587e3adcd1.pdf 68516.AAM.pdf 2024-12-19T16:15:54.6264779 Output 830543 application/pdf Accepted Manuscript true Author accepted manuscript document released under the terms of a Creative Commons CC-BY licence using the Swansea University Research Publications Policy (rights retention). true eng https://creativecommons.org/licenses/by/4.0/
title Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer
spellingShingle Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer
Paul Lewis
Claire Morgan
title_short Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer
title_full Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer
title_fullStr Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer
title_full_unstemmed Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer
title_sort Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer
author_id_str_mv 46dfc22d7468f247c390ba0c6cd8fba6
52c886f26c1b4d9d817000ac6e58a486
author_id_fullname_str_mv 46dfc22d7468f247c390ba0c6cd8fba6_***_Paul Lewis
52c886f26c1b4d9d817000ac6e58a486_***_Claire Morgan
author Paul Lewis
Claire Morgan
author2 Anita M. Huws
Gareth R. Davies
Paul Lewis
Claire Morgan
format Journal article
container_title Clinical Breast Cancer
container_volume 0
publishDate 2024
institution Swansea University
issn 1526-8209
1938-0666
doi_str_mv 10.1016/j.clbc.2024.11.022
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
document_store_str 1
active_str 0
description Background: Adjuvant therapy decisions in hormone receptor positive and human epidermal growth factor receptor 2 negative breast cancer are evolving. The introduction of gene panel testing has significantly reduced the number of patients recommended for chemotherapy by up to two thirds. However, these tests are expensive, highlighting the need to identify low-risk genomic breast cancer cases before testing, which could represent a significant economic impact. The use of systemic inflammatory indices has shown promise as prognostic markers in early breast cancer. We investigated the potential utility of four systemic inflammatory indices with the Nottingham Prognostic Index to predict the Oncotype DX® recurrence scores threshold level (low score or high score), in a cohort of women aged 50 and over with node negative invasive ductal carcinoma of the breast. Methods: A retrospective review of patients who had Oncotype DX® Recurrence Score testing from 2007 to 2021 were identified. After exclusions, the final sample size was 245. Clinicopathological features were collected to calculate the Nottingham Prognostic Index. The systemic inflammatory indices were estimated from preoperative peripheral blood samples. Results: 22.4% of the cohort had a Recurrence Score in the higher risk group. This cohort had a greater percentage of grade 3 tumours, progesterone receptor negativity, higher Nottingham Prognostic Scores, and inflammatory indices ratios than the lower risk group. A decision tree incorporating the Neutrophil Lymphocyte Ratio with clinicopathological features showed potential as an indicator of a high Oncotype DX® RS score, such that further investigation is warranted to assess whether Recurrence Score testing could be triaged in certain cohorts of patients. In this cohort, 38% of patients might be able to avoid genomic testing based on the decision tree analysis. Conclusion: Utility of the inflammatory indices with clinicopathological features may help triage gene panel testing.
published_date 2024-12-07T08:29:06Z
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score 11.059957

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