University Hospital - Medical Oncology Department, Besançon, France
Elsa Curtit , Julie Henriques , Sophie Paget-Bailly , Sylvain Ladoire , Ariane Darut-Jouve , Marc Debled , Gilles Romieu , Claire Garnier-Tixidre , Jean-Philippe Jacquin , Patrick Soulie , Christelle Jouannaud , Maria Rios , Thierry Petit , Thomas Denis Bachelot , Céline Faure-Mercier , Laetitia Gambotti , Hélène Blanché , Jean-Francois Deleuze , David Cox , Xavier Pivot
Background: Triple-negative breast cancers (TNBC) are a heterogeneous group of tumors with poor outcome. In this study, the association between germline genetic variants and invasive disease-free survival (iDFS) was analyzed in TNBC patients. Methods: A genome wide-association study (GWAS) aimed to identify variants (single nucleotide polymorphisms – SNPs) associated with prognosis in 1121 patients with TNBC in the SIGNAL prospective cohort. Associations between gene variants and iDFS were assessed in univariate Cox regression models. Variants were combined in a score to identify risk categories. A prognostic model based on breast cancer stage and genetic variants was estimated using a multivariate Cox regression. Interaction between stage and genetic score was tested. Discrimination of the model was assessed by the Harrell’s C statistic and internal validity by bootstrap method. Results: The characteristics of the 1121 patients were representative of a population with early TNBC. Four SNPs on chromosomes 9 and 2 were found significantly associated to iDFS in univariate Cox models. Homozygous status for the most frequent allele was associated with poorer iDFS for two SNPs and this status was present in 50% and 57% of the population. For the two other SNPs, the most frequent allele was associated with more favorable iDFS. Three prognostic categories were derived from the genetic score. The following table presents the results from the multivariate Cox model including genetic score and disease stage. Clinical trial information: RECF1098.Conclusions: In a prospective cohort of 1121 patients with early TNBC, 4 genetic variants (SNPs) were associated with iDFS. A score involving SNPs provided similar prognostic indications as breast cancer stages. A search assessing the function and the role of the involved genes is ongoing.
n (events) | HR | 95%CI | Bootstrap 95% CI | pvalue | ||
---|---|---|---|---|---|---|
1017* (204) | ||||||
stage | I | 347 (40) | 1 | < 0,0001 | ||
II | 484 (90) | 1,64 | 1,13-2,38 | 1,00-2,83 | ||
III | 177 (74) | 4,86 | 3,31-7,15 | 3,03-8,7 | ||
score | low | 652 (93) | 1 | < 0,0001 | ||
medium | 311 (90) | 2,29 | 1,71-3,06 | 1,52-3,37 | ||
high | 45 (21) | 4,58 | 2,85-7,37 | 2,15-9,37 |
* missing data: 104 / C-Harrell at 0.71 (95% CI 0.67-0.75) No significant interaction was found between stage and genetic score (p = 0.5184).
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