The largest cohort of its kind reveals notable genomic features among young premenopausal women with HR-positive early breastcancer and could represent key targets for therapy.
have notable genomic features that may help explain their historically poor outcomes and offer clues about molecular targets for future trials.
Charis Eng, MD, PhD, of the Cleveland Clinic Genomic Medicine Institute, Ohio, noted that the findings are promising but need further validation. Although previous studies have identified key gene expression signatures linked to worse outcomes in younger patients with breast cancer, there are limited data on this younger patient population, especially by breast cancer subtype. Given that breast cancer treatment strategies are often similar across age groups, such evidence gaps could represent missed opportunities for developing more targeted treatment strategies for this high-risk population of young women.
Younger women also had significantly higher features suggestive of homologous recombination deficiency , and a higher proportion of PIK3CA mutations with concurrent copy number-amplifications , all considered to be poor prognostic features. Compared with women without those features, women with poor prognostic features had a lower 8-year distant recurrence-free interval of 84% vs 94% , and worse 8-year overall survival of 88% vs 96%, respectively . Notably, younger women under age 40 had the poorest outcomes, with an 8-year distant recurrence-free interval rate of 74% vs 85% in older women, and an 8-year overall survival of 80% vs 93%, respectively.
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