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Abstract：
BACKGROUND: Breast cancer (BC) remains a significant health care challenge, and treatment approaches continue to evolve. Among these, neoadjuvant endocrine therapy (NET) has gained prominence, particularly for postmenopausal, hormone-receptor positive, HER2-negative (HR+/HER2-) BC patients. Despite this, a significant gap exists in identifying patients who stand to benefit from NET. The objective of this study was to assess whether Magee equations (MEs) could serve as predictors of response to NET.
METHODS: This retrospective study included adult patients with invasive BC who underwent NET followed by curative surgery. Assessment of sociodemographic, clinical, and tumor-related variables was conducted. The ME1, ME2, ME3, and ME mean were analyzed to explore their predictive role for NET response. Receiver operating characteristic (ROC) curves were employed, along with the determination of optimal cutoff points. Logistic regression models were utilized to identify the most significant predictors of pathological response.
RESULTS: Among the 75 female participants, the mean age was 69.4 years, with the majority being postmenopausal (n = 72, 96%) and having an ECOG-PS of 0/1 (n = 63, 84%). Most patients were classified as luminal A (n = 41, 54.7%). ME3 emerged as a promising predictor, boasting an AUC of 0.734, with sensitivity of 90.62% and specificity of 57.50% when the threshold was ≤ 19.97. In univariate analysis, clinical staging (p = 0.002), molecular subtype (p = 0.001), and ME3 (continuous = 0.001, original 3-tier: p = 0.013, new 2-tier: <0.001) categories exhibited significant associations with pathological response. In the multivariate model, clinical staging and new 2-tier ME3 (<20 vs. ≥20) were included as significant variables.
CONCLUSIONS: Patients with ME3 < 20 have a higher likelihood of presenting a pathological response, offering a cost-effective alternative tool to Oncotype DX. Larger future studies with a prospective design are awaited to confirm our findings.
METHODS: This retrospective study included adult patients with invasive BC who underwent NET followed by curative surgery. Assessment of sociodemographic, clinical, and tumor-related variables was conducted. The ME1, ME2, ME3, and ME mean were analyzed to explore their predictive role for NET response. Receiver operating characteristic (ROC) curves were employed, along with the determination of optimal cutoff points. Logistic regression models were utilized to identify the most significant predictors of pathological response.
RESULTS: Among the 75 female participants, the mean age was 69.4 years, with the majority being postmenopausal (n = 72, 96%) and having an ECOG-PS of 0/1 (n = 63, 84%). Most patients were classified as luminal A (n = 41, 54.7%). ME3 emerged as a promising predictor, boasting an AUC of 0.734, with sensitivity of 90.62% and specificity of 57.50% when the threshold was ≤ 19.97. In univariate analysis, clinical staging (p = 0.002), molecular subtype (p = 0.001), and ME3 (continuous = 0.001, original 3-tier: p = 0.013, new 2-tier: <0.001) categories exhibited significant associations with pathological response. In the multivariate model, clinical staging and new 2-tier ME3 (<20 vs. ≥20) were included as significant variables.
CONCLUSIONS: Patients with ME3 < 20 have a higher likelihood of presenting a pathological response, offering a cost-effective alternative tool to Oncotype DX. Larger future studies with a prospective design are awaited to confirm our findings.
摘要：
背景：乳腺癌（BC）仍然是一个重大的医疗保健挑战，和治疗方法继续发展。其中,新辅助内分泌治疗(NET)日益受到重视，特别是绝经后，激素受体阳性,HER2阴性（HR+/HER2-）BC患者。尽管如此,在确定从网络中受益的患者方面存在显著差距。这项研究的目的是评估马吉方程（ME）是否可以作为对NET反应的预测因子。
方法：这项回顾性研究包括接受NET治疗后接受根治性手术的侵袭性BC成年患者。社会人口统计学评估，临床,并进行了肿瘤相关变量。分析ME1、ME2、ME3和ME平均值以探索它们对NET反应的预测作用。采用受试者工作特征(ROC)曲线，以及最佳截止点的确定。使用Logistic回归模型来确定病理反应的最重要预测因子。
结果：在75名女性参与者中，平均年龄是69.4岁,大多数为绝经后（n=72，96％），ECOG-PS为0/1（n=63，84％）。大多数患者被分类为管腔A（n=41，54.7％）。ME3成为一个有希望的预测指标，当阈值≤19.97时，AUC为0.734，灵敏度为90.62％，特异性为57.50％。在单变量分析中，临床分期（p=0.002），分子亚型（p=0.001），和ME3（连续=0.001，原始3层：p=0.013，新2层：<0.001）类别与病理反应显着相关。在多变量模型中，临床分期和新的2层ME3（<20vs.≥20)作为显著变量。
结论：ME3<20的患者出现病理反应的可能性更高，为OncotypeDX提供具有成本效益的替代工具。等待具有前瞻性设计的更大的未来研究来证实我们的发现。
方法：这项回顾性研究包括接受NET治疗后接受根治性手术的侵袭性BC成年患者。社会人口统计学评估，临床,并进行了肿瘤相关变量。分析ME1、ME2、ME3和ME平均值以探索它们对NET反应的预测作用。采用受试者工作特征(ROC)曲线，以及最佳截止点的确定。使用Logistic回归模型来确定病理反应的最重要预测因子。
结果：在75名女性参与者中，平均年龄是69.4岁,大多数为绝经后（n=72，96％），ECOG-PS为0/1（n=63，84％）。大多数患者被分类为管腔A（n=41，54.7％）。ME3成为一个有希望的预测指标，当阈值≤19.97时，AUC为0.734，灵敏度为90.62％，特异性为57.50％。在单变量分析中，临床分期（p=0.002），分子亚型（p=0.001），和ME3（连续=0.001，原始3层：p=0.013，新2层：<0.001）类别与病理反应显着相关。在多变量模型中，临床分期和新的2层ME3（<20vs.≥20)作为显著变量。
结论：ME3<20的患者出现病理反应的可能性更高，为OncotypeDX提供具有成本效益的替代工具。等待具有前瞻性设计的更大的未来研究来证实我们的发现。
