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Åke Borg

Åke Borg

Principal investigator

Åke Borg

RNA sequencing-based single sample predictors of molecular subtype and risk of recurrence for clinical assessment of early-stage breast cancer

Author

  • Johan Staaf
  • Jari Häkkinen
  • Cecilia Hegardt
  • Lao H Saal
  • Siker Kimbung
  • Ingrid Hedenfalk
  • Tonje Lien
  • Therese Sørlie
  • Bjørn Naume
  • Hege Russnes
  • Rachel Marcone
  • Ayyakkannu Ayyanan
  • Cathrin Brisken
  • Rebecka R Malterling
  • Bengt Asking
  • Helena Olofsson
  • Henrik Lindman
  • Pär-Ola Bendahl
  • Anna Ehinger
  • Christer Larsson
  • Niklas Loman
  • Lisa Rydén
  • Martin Malmberg
  • Åke Borg
  • Johan Vallon-Christersson
Show all

Summary, in English

Multigene assays for molecular subtypes and biomarkers can aid management of early invasive breast cancer. Using RNA-sequencing we aimed to develop single-sample predictor (SSP) models for clinical markers, subtypes, and risk of recurrence (ROR). A cohort of 7743 patients was divided into training and test set. We trained SSPs for subtypes and ROR assigned by nearest-centroid (NC) methods and SSPs for biomarkers from histopathology. Classifications were compared with Prosigna in two external cohorts (ABiM, n = 100 and OSLO2-EMIT0, n = 103). Prognostic value was assessed using distant recurrence-free interval. Agreement between SSP and NC for PAM50 (five subtypes) was high (85%, Kappa = 0.78) for Subtype (four subtypes) very high (90%, Kappa = 0.84) and for ROR risk category high (84%, Kappa = 0.75, weighted Kappa = 0.90). Prognostic value was assessed as equivalent and clinically relevant. Agreement with histopathology was very high or high for receptor status, while moderate for Ki67 status and poor for Nottingham histological grade. SSP and Prosigna concordance was high for subtype (OSLO-EMIT0 83%, Kappa = 0.73 and ABiM 80%, Kappa = 0.72) and moderate and high for ROR risk category (68 and 84%, Kappa = 0.50 and 0.70, weighted Kappa = 0.70 and 0.78). Pooled concordance for emulated treatment recommendation dichotomized for chemotherapy was high (85%, Kappa = 0.66). Retrospective evaluation suggested that SSP application could change chemotherapy recommendations for up to 17% of postmenopausal ER+/HER2-/N0 patients with balanced escalation and de-escalation. Results suggest that NC and SSP models are interchangeable on a group-level and nearly so on a patient level and that SSP models can be derived to closely match clinical tests.

Department/s

  • LUCC: Lund University Cancer Centre
  • Research Group Lung Cancer
  • Breastcancer-genetics
  • Translational Oncogenomics
  • Breast cancer prevention & intervention
  • Breast and Ovarian Cancer Genomics
  • The Liquid Biopsy and Tumor Progression in Breast Cancer
  • Personalized Breast Cancer Treatment
  • Pathology, Lund
  • Tumor Cell Biology
  • Breast/ovarian cancer
  • Breast Cancer Surgery
  • Familial Breast Cancer

Publishing year

2022-08-16

Language

English

Pages

1-17

Publication/Series

npj Breast Cancer

Volume

8

Document type

Journal article

Publisher

Nature Publishing Group

Topic

  • Cancer and Oncology

Status

Published

Project

  • Sweden Cancerome Analysis Network - Breast (SCAN-B): a large-scale multicenter infrastructure towards implementation of breast cancer genomic analyses in the clinical routine

Research group

  • Research Group Lung Cancer
  • Translational Oncogenomics
  • Breast cancer prevention & intervention
  • Breast and Ovarian Cancer Genomics
  • The Liquid Biopsy and Tumor Progression in Breast Cancer
  • Personalized Breast Cancer Treatment
  • Tumor Cell Biology
  • Breast Cancer Surgery
  • Familial Breast Cancer

ISBN/ISSN/Other

  • ISSN: 2374-4677