iScience (Aug 2024)

Predictive gene expression profile for adjuvant taxane benefit in breast cancer in the MATADOR trial

  • Mark Opdam,
  • Annelot G.J. van Rossum,
  • Marlous Hoogstraat,
  • Gergana Bounova,
  • Hugo M. Horlings,
  • Erik van Werkhoven,
  • Ingrid A.M. Mandjes,
  • A. Elise van Leeuwen – Stok,
  • Sander Canisius,
  • Harm van Tinteren,
  • Alex L.T. Imholz,
  • Johanneke E.A. Portielje,
  • Monique E.M.M. Bos,
  • Sandra Bakker,
  • Jelle Wesseling,
  • Lennart Kester,
  • Jacco van Rheenen,
  • Emiel J. Rutgers,
  • Renee X. de Menezes,
  • Lodewyk F.A. Wessels,
  • Marleen Kok,
  • Hendrika M. Oosterkamp,
  • Sabine C. Linn,
  • Sabine C. Linn,
  • Marcel Soesan,
  • Rianne M. Oosterkamp,
  • Frank Jeurissen,
  • Nir Weijl,
  • Alex L.T. Imholz,
  • Johanneke E.A. Portielje,
  • Karin J. Beelen,
  • Monique E.M.M. Bos,
  • Aart van Bochove,
  • Gerty de Klerk,
  • Suzan Vrijaldenhoven,
  • Annette van der Velden,
  • Hiltje de Graaf,
  • Marielle Smeets,
  • Jetske Meerum Terwogt,
  • Jolanda Schrama,
  • Philomeen Kuijer,
  • Hanneke Wilmink,
  • Ronald Hoekstra,
  • Judith Kroep,
  • Hans F.M. Pruijt,
  • Leander van Gerven,
  • Allert H. Vos,
  • Frans Erdkamp,
  • Willemien G. van Leeuwen-Breuk,
  • Alexander de Graeff

Journal volume & issue
Vol. 27, no. 8
p. 110425

Abstract

Read online

Summary: The primary objective of the prospective, randomized, multicenter, phase 3 biomarker Microarray Analysis in breast cancer to Taylor Adjuvant Drugs Or Regimens trial (MATADOR: ISRCTN61893718) is to generate a gene expression profile that can predict benefit from either docetaxel, doxorubicin, and cyclophosphamide (TAC) or dose-dense scheduled doxorubicin and cyclophosphamide (ddAC). Patients with a pT1-3, pN0-3 tumor were randomized 1:1 between ddAC and TAC. The primary endpoint was a gene profile-treatment interaction for recurrence-free survival (RFS). We observed 117 RFS events in 664 patients with a median follow-up of 7 years. Hallmark gene set analyses showed significant association between enrichment in immune-related gene expression and favorable outcome after TAC in hormone receptor-negative, human epidermal growth factor receptor 2 (HER2)-negative breast cancer (BC) (triple-negative breast cancer [TNBC]). We validated this association in TNBC patients treated with TAC on H&E slides; stromal tumor-infiltrating lymphocytes (sTILs) ≥20% was associated with longer RFS (hazard ratio 0.18, p = 0.01), while in patients treated with ddAC no difference in RFS was seen (hazard ratio 0.92, p = 0.86, pinteraction = 0.02).

Keywords