On December 9, 2016 Myriad Genetics, Inc. (NASDAQ:MYGN), a leader in molecular diagnostics and personalized medicine, reported results of a large head-to-head study comparing the efficacy of six tests used to predict the recurrence of breast cancer (Press release, Myriad Genetics, DEC 9, 2016, View Source [SID1234517014]). A key finding was that EndoPredict (EPclin), a second-generation test, was superior to Oncotype Dx (RS), a first-generation test, in predicting the long-term recurrence of breast cancer. The results are being featured today in a podium presentation at the 2016 San Antonio Breast Cancer Symposium (SABCS) in San Antonio, Texas.
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"In this important study, EndoPredict more accurately predicted the risk of breast cancer recurrence than the first-generation Oncotype Dx test, particularly in years five to 10 following surgery when half of breast cancer recurrences will happen," said Johnathan Lancaster, M.D., Ph.D., chief medical officer, Myriad Genetic Laboratories. "Clinicians can consider using EndoPredict to identify patients who can forgo chemotherapy with confidence, knowing they have a low risk of recurrence over 10 years."
Podium Presentation
Title: Comprehensive comparison of prognostic signatures for breast cancer in TransATAC.
Presenter: Ivana Sestak, Ph.D.
Date: Friday, Dec.9, 2016: 4:15 p.m. CT.
Location: S6-05; General Session 6 – Hall 3.
This study was led by scientists at the Institute of Cancer Research in London. The analysis included 818 women with ER+/HER2- breast cancer (591 node-negative; 227 node-positive) from the TransATAC study and compared the power of six predictive signatures, including: clinical treatment score, immunohistochemical markers, Oncotype Dx recurrence score (RS), breast cancer index (BCI), Prosigna and EndoPredict (EPClin). Distant recurrence of breast cancer was the primary endpoint and the median follow-up period was 10 years.
Overall, each of the three second-generation tests evaluated (breast cancer index, Prosigna and EndoPredict) outperformed Oncotype Dx in this cohort in predicting the recurrence of breast cancer in both node-negative and node-positive patients across both zero to 10 and five to 10 years post-surgery. In a head-to-head comparison between EndoPredict and Oncotype Dx in this study:
EndoPredict offered more predictive power than Oncotype Dx across zero to 10 years.
The data show that the likelihood ratio (LRx2, a common measure of predictive power) for EndoPredict was almost double that of Oncotype Dx in node-negative patients (EndoPredict: LRX2= 40.6; Oncotype: LRX2=22.8) and was five times higher in node-positive patients (EndoPredict: LRX2= 35.6; Oncotype: LRX2=6.4).
EndoPredict had superior predictive power over Oncotype Dx between five to 10 years.
The likelihood ratio for EndoPredict was seven times higher than for Oncotype Dx in node-negative patients (EndoPredict: LRX2= 24.0; Oncotype: LRX2=3.4) and 13 times higher in node-positive patients (EndoPredict: LRX2= 14.9; Oncotype: LRX2=1.1). Importantly, the likelihood ratio for Oncotype DX failed to achieve statistical significance in predicting cancer recurrence in years five to 10 for either node-positive or node-negative patients, indicating an inability to predict distant recurrence over the five to 10 year timeframe.
EndoPredict was superior in classifying node-positive patients as low-risk compared to Oncotype Dx.
Node-positive patients classified as low risk by EndoPredict had a substantially lower 10-year recurrence rate (5.6 percent) than patients classified as low risk by Oncotype Dx (26.2 percent) as well as a lower five to 10 year recurrence rate (3.3 percent for EndoPredict vs 17.9 percent for Oncotype Dx).
"Myriad is committed to research that improves care for patients with breast cancer. Patients at high risk of cancer recurrence are candidates for adjuvant chemotherapy after surgery, while those at low risk can be spared chemotherapy and the side effects," said Lancaster. "We believe EndoPredict will help clinicians and patients understand the risk of breast cancer recurrence and identify more patients who can safely forgo chemotherapy. Additionally, EndoPredict does not contain an intermediate risk category and each patient receives a clear test result, allowing oncologists to confidently develop their treatment plan."
The TransATAC study, in part, was previously published in the Journal of the National Cancer Institute (View Source). The current presentation at SABCS expands on that article and provides a comprehensive comparison of prognostic signatures for breast cancer. Follow Myriad on Twitter via @MyriadGenetics and stay informed about symposium news and updates by using the hashtag #SABCS16.