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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Wimmer, K; Hlauschek, D; Balic, M; Pfeiler, G; Greil, R; Singer, CF; Halper, S; Steger, G; Suppan, C; Gampenrieder, SP; Helfgott, R; Egle, D; Filipits, M; Jakesz, R; Sölkner, L; Fesl, C; Gnant, M; Fitzal, F, , Austrian, Breast, &, Colorectal, Cancer, Study, Group.
Validation of the CTS5 in four prospective, multicenter, randomized ABCSG trials.
Breast. 2025; 80:104415
Doi: 10.1016/j.breast.2025.104415
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- Co-authors Med Uni Graz
- Balic Marija
- Suppan Christoph
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- Abstract:
- BACKGROUND: The Clinical Treatment Score post-5 years (CTS5) is a clinicopathological tool designed to estimate late distant recurrence (LDR) in hormone receptor-positive (HR+) breast cancer patients after 5 years of adjuvant endocrine therapy (ET). While intended as a prognostic algorithm, its predictive value for ET extension remains uncertain. METHODS: The score was calculated in 4931 patients from four prospective randomized ABCSG trials (ABCSG-6, -6a, -8, and -16) with 250 LDR events. We assessed its prognostic power, calibration accuracy, and predictive value. Time to LDR was analyzed using Cox regression models. RESULTS: In our cohorts, the CTS5 provided prognostic information whether used as a continuous or categorical score. In the ABCSG-8 cohort (n = 2054) and the combined ABCSG-6+8 cohort (n = 3308), a higher continuous score was significantly associated with increased LDR risk. The categorical CTS5 showed that high-risk patients had significantly higher LDR rates compared to low- or intermediate-risk patients. The score slightly overestimated LDR risk, regardless of predicted risk. Although no significant predictive value was found on the relative scale, an absolute LDR risk reduction of 23.4 % was found in patients with a high CTS5 of 5 when extended ET was administered additional five than two years. In patients with a CTS5 of 2, no benefit was found when ET was extended to 10 instead of 7 years. CONCLUSION: The CTS5 is a valid tool for LDR risk stratification in HR + breast cancer, but should be used cautiously for determining benefits from ET extension, as no significant predictive value was found.
- Find related publications in this database (Keywords)
- CTS5
- Adjuvant setting
- Endocrine therapy
- Predictive value
- Late distant recurrence