Abstract PS9-10: Can composite risk model help clinicians make adjuvant ovary function suppression dicision for breast cancer patients
Authors: Liang Yue , Chen Xiaosong , Gao Weiqi , Zhu Siji , Hong Jin , Wu Jiayi , Huang Ou , He Jianrong , Zhu Li , Li Yafen , Chen Weiguo , Shen Kunwei 
Published: February 2021

Background: Composite measure of recurrence risk with certain clinicopathologic characteristics provided prognostic and adjuvant ovarian function suppression (OFS) therapeutic effect information for patients in the TEXT and SOFT trials, but the role of this composite risk score (CRS) in OFS treatment decision-making has not been established. We carry out this study to evaluate the association of CRS with OFS treatment recommendation in our multidisciplinary team (MDT) treated patient cohort.Methods: Premenopausal patients with hormone receptor (HR) positive, human epidermal growth factor receptor 2 (HER2) negative breast cancer who received surgery between April 2013 and December 2018 and had OFS decision-making made by MDT were included. The association of CRS with OFS recommendation and survival outcome were analyzed.Results: Totally 887 patients were identified, amongst which 239 (26.94%) were recommended to receive OFS. The median CRS was 1.92, 455 (51.3%) patients were categorized as low-risk and 432 (48.7%) as high-risk. Age &lt; 35 years (OR = 24.68, 95% CI 12.97-46.95, P &lt; 0.001), ≥ 4 ALNs metastasis (OR = 3.95, 95% CI 2.08-7.48, P &lt; 0.001), ER ≥ 50% (OR = 5.45, 95% CI 2.16-13.75, P &lt; 0.001) and CRS high-risk (OR = 2.82, 95% CI 1.62-4.91, P &lt; 0.001) were independently predictive of OFS recommendation. CRS also served as an effective predictor of OFS recommendation in receiver operating characteristics (ROC) curve analysis (AUC = 0.775, P &lt; 0.001). CRS high-risk was related to worse breast cancer-free interval (BCFI) (89% vs. 97.6%, HR 8.98, 95% CI 2.73-29.51, P &lt; 0.001), no significant differences in overall survival (OS) were found between patients with CRS high and low-risk (96.5% vs. 99.8%, HR 5.5, 95% CI 0.66-45.73, P = 0.076).Conclusions: CRS was associated with OFS recommendation and BCFI in premenopausal patients with HR positive/HER2 negative breast cancer, which may be integral to their individualized OFS treatment decision-making.

Table 1. Clinicopathologic characteristics, CRS and OFS recommendationUnivariate analysisMultivariate analysischaracteristicsNo-OFS N = (%)OFS N = (%)P valueOR95% CIP valueAge (years)&lt; 0.001&lt; 0.001&lt; 3521 (23.33)69 (76.67)24.6812.97-46.95&lt; 0.00135-3940 (30.77)90 (69.23)22.8713.59-38.48&lt; 0.001≥ 40587 (88.01)80 (11.99)1Histologic grade&lt; 0.0010.054I84 (94.38)5 (5.62)1II409 (73.96)144 (26.04)3.691.28-10.650.016III155 (63.27)90 (36.73)3.481.11-10.860.032Tumor size0.0120.172≤ 2cm428 (75.89)136 (24.11)1&gt; 2cm220 (68.11)103 (31.89)0.720.45-1.15ALN status&lt; 0.001&lt; 0.0010421 (80.04)105 (19.96)11-3171 (68.95)77 (31.05)1.91.14-3.170.014≥ 456 (49.56)57 (50.44)3.952.08-7.48&lt; 0.001ER0.022&lt; 0.001&lt; 50%53 (85.48)9 (14.52)1&gt; 50%595 (72.12)230 (27.88)5.452.16-13.75PR0.052&lt; 50%202 (68.94)91 (31.06)≥ 50%446 (75.08)148 (24.92)Ki67&lt; 0.0010.466&lt; 14%270 (84.38)50 (15.63)114%-19%48 (70.59)20 (29.41)1.650.77-3.530.20220%-25%127 (73.84)45 (26.16)1.110.6-2.060.747≥ 26%203 (62.08)124 (37.92)1.430.8-2.560.231CRS&lt; 0.001&lt; 0.001≤ 1.92405 (89.01)50 (10.99)1&gt; 1.92243 (56.25)189 (43.75)2.821.62-4.91

Table 2. ROC analysis for prediction of OFS recommendationcharacteristicsAUCP valueAge (years)0.109&lt;0.001Histologic grade0.601&lt;0.001Tumor size0.596&lt;0.001ALN status0.624&lt;0.001ER0.5140.53PR0.4420.008Ki670.622&lt;0.001CRS0.775&lt;0.001

Citation Format: Yue Liang, Xiaosong Chen, Weiqi Gao, Siji Zhu, Jin Hong, Jiayi Wu, Ou Huang, Jianrong He, Li Zhu, Yafen Li, Weiguo Chen, Kunwei Shen. Can composite risk model help clinicians make adjuvant ovary function suppression dicision for breast cancer patients [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-10.