Aim: To develop a prognostic score for primary breast cancer patients integrating conventional predictors and the novel biomarker CHAC1 to aid adjuvant chemotherapy decisions. Patients & methods: A prognostic score for overall survival was developed using: conventional predictors from a dataset of 1777 patients and the weight of CHAC1 mRNA expression from an independent dataset of 106 patients using multivariate Cox regression. Results: The new score includes: CHAC1 mRNA expression, age, tumor size, HER2 neu status, lymph node status and degree of malignancy. Using a cut-off value of 11 score points, 10-year survival was 82% in low-risk (n = 34) and 43% in high-risk patients (n = 72). The addition of CHAC1 resulted in 16% reclassification. Conclusion: Including CHAC1 in prognostic prediction may aid (and change) personalized treatment selection.
Prognostic scores are important for informing patients about potential clinical outcomes, supporting physicians choices about diagnostic tests and appropriate therapies, studying the effect of specific factors on prognosis in observational studies and designing randomized controlled trials . Such scores have an important role in personalized medicine, which aims to improve patient stratification and timing of healthcare interventions by using biological information and biomarkers. Treatments with known adverse effects should only be offered to patients who have a substantial chance of benefit .
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