PREDICT Underestimates Survival of Patients with HER2-positive Early-stage Breast Cancer

Overview

Journal NPJ Breast Cancer

Date 2022 Jul 20

PMID 35859079

Authors

Elisa Agostinetto

Lieveke Ameye

Samuel Martel

Philippe Aftimos

Noam Ponde

Christian Maurer

Sarra El-Abed

Yingbo Wang

Malou Vicente

Saranya Chumsri

Judith Bliss

Judith Kroep

Marco Colleoni

Fausto Petrelli

Lucia Del Mastro

Alvaro Moreno-Aspitia

Martine Piccart

Marianne Paesmans

Evandro de Azambuja

Matteo Lambertini

Affiliations

Soon will be listed here.

Abstract

The prognostic performance of PREDICT in patients with HER2-positive early breast cancer (EBC) treated in the modern era with effective chemotherapy and anti-HER2 targeted therapies is unclear. Therefore, we investigated its prognostic performance using data extracted from ALTTO, a phase III trial evaluating adjuvant lapatinib ± trastuzumab vs. trastuzumab alone in patients with HER2-positive EBC. Our analysis included 2794 patients. After a median follow-up of 6.0 years (IQR, 5.8-6.7), 182 deaths were observed. Overall, PREDICT underestimated 5-year OS by 6.7% (95% CI, 5.8-7.6): observed 5-year OS was 94.7% vs. predicted 88.0%. The underestimation was consistent across all subgroups, including those according to the type of anti HER2-therapy. The highest absolute differences were observed for patients with hormone receptor negative-disease, nodal involvement, and large tumor size (13.0%, 15.8%, and 15.3%, respectively). AUC under the ROC curve was 73.7% (95% CI 69.7-77.8) in the overall population, ranging between 61.7% and 77.7% across the analyzed subgroups. In conclusion, our analysis showed that PREDICT highly underestimated OS in HER2-positive EBC. Hence, it should be used with caution to give prognostic estimation to HER2-positive EBC patients treated in the modern era with effective chemotherapy and anti-HER2 targeted therapies.

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