“Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT...
Transcript of “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT...
![Page 1: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/1.jpg)
“Senonetwork: incontro centri di senologia 5.0”
![Page 2: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/2.jpg)
![Page 3: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/3.jpg)
9000 eBC
6000 HR+/HER2-
2200 Intermediate clinical-pathologic risk
BACKGROUNDAnnual incidence Lombardia
Systemic risk
<10% 10-25% >25%
![Page 4: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/4.jpg)
9000 eBC
6000 HR+/HER2-
2200 Intermediate clinical-pathologic risk
HT only CT + HT
?
HT +/- CT G
T
Ki67
N
ER
![Page 5: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/5.jpg)
PROSPECTIVE MULTICENTER STUDY ON THE IMPACT OF THE 21-GENE RECURRENCE SCORE IN ADJUVANT CLINICAL DECISIONS FOR PATIENTS WITH ER+/HER2-BREAST CANCER IN LOMBARDY (BONDX STUDY)
Piacentini G, Zambelli A, Sansi C, Gianatti A, Chirco A, Fotia V, Livraghi L, Poletti PL, Rota Caremoli E, Laverde N, Giordano M, Simoncini E, Torri V, Tondini CA
H Papa Giovanni XXIII Bergamo, H Spedali Civili Brescia, H St Anna Como , H Fatebenefratelli Milan, Mario Negri Institute Milan
![Page 6: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/6.jpg)
Consort
1428 consecutive eBC
1082 HR+/HER2-
pT1-3, pN0-1 (max 3N+)
Intermediate/LowRisk
Intermediate Risk(IR)
n = 398
Enrolled
n = 394
No IC
n=1
pT(m)
n = 3
Intermediate/High Risk
Intermed/Low Risk (≥ 4)
G1
T1a-b
Ki67 < 15%
N0
ER > 80%
Intermed/High Risk (≥ 4)
G3
T > 2
Ki67 > 30%
N+
ER < 30%
From Jan 2017 to Jul 2018
![Page 7: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/7.jpg)
237 (60%)134 (34%)
23 (6%)
RS low (< 18) RS medium (18 - 31) RS high (> 31)
RS distribution (n = 394)
![Page 8: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/8.jpg)
RS distribution (I)
68,8%
39,2%
2,7%
30,5%
55,8%
54,1%
0,6% 5,0%
43,2%
RS <18 RS 18-30 RS >30
KI67 <= 15 KI67 16-34 Ki67 >=35
82,3%
17,7%
0,0%
66,8%
31,0%
2,2%
38,5%
45,2%
16,3%
RS <18 RS 18-30 RS >30
G1 G2 G3
62,2% 32,2%5,6%
67,4% 29,0%3,6%
RS <18 RS 18-30 RS >30
N0 N1
19,0%
63,8%17,2%
55,9%
37,8%6,3%
RS <18 RS 18-30 RS >30
PgR<10 PgR>10
![Page 9: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/9.jpg)
Initial RecommendationPre-Test
CT: 25 %
HT: 75 %
97
297
n = 394
![Page 10: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/10.jpg)
61
333
CT: 15 %
HT: 85 %
Final RecommendationPost-Test
![Page 11: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/11.jpg)
12
285
Post-test RecommendationHT >CT
![Page 12: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/12.jpg)
97
12
Post-test RecommendationHT >CT
![Page 13: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/13.jpg)
48
49
Post-test RecommendationCT > HT
![Page 14: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/14.jpg)
4912
Post-test RecommendationCT > HT
48
![Page 15: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/15.jpg)
D: 15.2 %60 pts
D: 49.5%48 pts
D: 4.0%12 pts
ALL
HT
CT
CT
HT
CT/HT
Change of Recommendation
![Page 16: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/16.jpg)
Number Needed to Test Pts recommended for HT
• eBC ER+
• ER+ IR
• ER+ IR HT
• ER+ IR HT-C
• NNT
![Page 17: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/17.jpg)
Number Needed to Test Pts recommended for CT
• eBC ER+
• ER+ IR
• ER+ IR CT
• ER+ IR CT-C
• NNT
Subgroup N0 rec. for CT (49)
D : 51% (25 pts) NNT: 2
![Page 18: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/18.jpg)
TAILORx RS=25
![Page 19: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/19.jpg)
9000 eBC
6000 HR+/HER2-
2200 Intermediate clinical-pathologic risk
HT only HT+CT
N= 600N= 1600N=64 (4%) N=300 (49,5%)
HT only
HT+CT
NTT=1:25 NTT= 1:2
![Page 20: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/20.jpg)
HT only
HT+CT
N= 2000N= 200N=8 (4%) N=1600 (80%)
HT onlyHT+CT
NTT=25:1 NTT= 5:4 D: -1600 CT
9000 eBC
6000 HR+/HER2-
2200 Intermediate clinical-pathologic risk
![Page 21: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/21.jpg)
HT only
HT+CT
N= 2000N= 200N=8 (4%) N=1600 (80%)
HT onlyHT+CT
NTT=25:1 NTT= 5:4 D: -1600 CT
9000 eBC
6000 HR+/HER2-
2200 Intermediate clinical-pathologic risk
1600 x7000 €= 11.200.000 €2000 x 3000 €= 6.000.000 €
1000 x7000 €= 7.000.000 €
![Page 22: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/22.jpg)
Thanks to
The Breast Unit Staff at:
- H Papa Giovanni XXIII Bergamo
- H Spedali Civili Brescia
- H St Anna Como
- H Fatebenefratelli Milan
- Mario Negri Institute Milan
The Genomic Health for supporting the tests
All women and families partecipatingto the study
![Page 23: “Senonetwork: incontro centri di senologia 5.0” · N=8 (4%) N= 200 N= 2000 =1600 (80%) HT+C HT only T NTT=25:1 NTT= 5:4 D: -1600 CT 9000 eBC 6000 HR+/HER2-2200 Intermediate clinical-pathologic](https://reader033.fdocuments.in/reader033/viewer/2022050601/5fa84b4148d3382edc2875eb/html5/thumbnails/23.jpg)
“Senonetwork: incontro centri di senologia 5.0”