Real-life Evaluation of Endopredict® in Early HR+/HER2- Breast Cancer

NCT07379918 | Recruiting

• 1 other identifier: APHP251664
• Study Type: observational
• Target: 1,000
• Locations: 1 country
• Sites: 1

Brief Summary

EndoPredict is a genomic signature used to determine the 10-year risk of recurrence in early HR+/HER2- breast cancers classified as of intermediate risk according to conventional clinical and pathological criteria, and to guide the adjuvant treatment decision: hormone therapy alone or hormone therapy and chemotherapy. Since 2016, french laboratories performing the Endopredict test, included prospectively analyzed tumors in the SiMoSein registry with data collection : age, tumor size, lymph node status, histology, grade, HR and HER2 IHC status, Ki67, EPscore, Epclin score, risk of relapse, absolue benefit from chemotherapy, risk of late relapse The main objectives of the trial are to: Evaluate long-term relapse-free survival and overall survival over a 10-year period in breast cancer patients who underwent EndoPredict® testing according to:

• EPclin risk class (low vs. high),
• Lymph node status (N0/N1),
• Tumor size (pT),
• Age groups (\<40 years, 40-49 years, 50-69 years, ≥70 years),
• EP score alone. This study provide real-life data to determine the clinical usefulness of this molecular signature in the management of early HR+/HER2- breast cancers. The ultimate goal is to be able to offer therapeutic de-escalation (avoiding chemotherapy) to patients who are reliably assessed as having a low risk of relapse.

Conditions

Breast Cancer (Early Breast Cancer); Breast Cancer Survivors; Breast Cancer Prognostic; Early Hormone Receptor-positive (HR-positive); HER2-negative Breast Cancer

Keywords

breast cancer; early breast cancer; EndoPredict test; survival; HR positive; HER2 negative

Outcome Measures

Primary Outcomes (1)

• Survival without relapse

  The survival is mesured on 10 years and is defined as absence of metastatic relapse related to cancer in patients which EPclin (score) is low, treated by hormone therapy alone. The criterion will be analyzed as a binary variable (event : yes/no)

  From the moment where the test is perfomed up to 10 years later.

Secondary Outcomes (6)

• Distant recurrence-free survival and overall survival

  From the moment where the test is performed up to 10 years later.

• Concordance rate between EPclin score and adjuvant treatment administrated

  10 years after the Endopredict test is perfomed

• Rate of change in treatment decision related to EPclin outcome

  10 years after the Endopredict is performed

• Description of clinical and pathological characteristics

  From the moment where the Endopredict test is performed up to 10 years later

• Correlation between clinical and pathological characteristics and EndoPredict® test results

  From the moment when the Endopredict test is perfomed to 10 years later

Interventions

Endopredict test OTHER

Endopredict test was perfomed between 2016 and 2021 in expert french laboratories, for patient with early HR+/HER2-breast cancer presenting insufficient clinical criteria to determine the need for adjuvant chemotherapy, in combination with hormone therapy, after breast surgery. Endopredict is a multigene signature that evaluates, on surgery tumor specimen, the expression of 11 genes (8 genes related to proliferation, apoptosis and HR signal transduction pathways and 3 control genes) by qRT-PCR to define a molecular EP score. The Ep score combined with two prognostic factors (tumour size pT and lymph node involvement pN) define the Epclin score. The Epclin score allows calculation of the risk of relapse at 10 years, the absolute benefit from chemoptherapy and the risk of late recurrence.

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients included in the SiMoSein prospective database between 2016 and 2021. That is, patients with luminal subtype breast cancer \[RE+/HER2-, N+ or N-), at an early stage of the disease, for whom uncertainty remains regarding the decision to administer adjuvant chemotherapy, according to standard clinical-pathological criteria, and for whom an Endopredict genomic signature has been recommended, performed, and interpreted. The study focuses on cancer centers affiliated with UNICANCER and APHP.

You may qualify if:

• Patient with early breast cancer, hormone receptor-positive, HER2 non-amplified, for whom clinical criteria are deemed insufficient to determine the need for adjuvant chemotherapy, combined with hormone therapy, after breast surgery.

You may not qualify if:

• Patients who did not undergo testing or whose test results were not validated

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead

Study Sites (1)

Hôpital Saint-Louis

Paris, France

RECRUITING

Related Publications (15)

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  BACKGROUND

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  BACKGROUND

• - Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge O, Pergamenschikov A, Williams C, Zhu SX, Lônning PE, Borresen-Dale AL, Brown PO, Botstein D. Molecular portraits of human breast tumours. Nature. 2000 Aug 17;406(6797):747-52

  BACKGROUND

• - Martin M, Brase JC, Calvo L, Krappmann K, Ruiz-Borrego M, Fisch K, Ruiz A, Weber KE, Munarriz B, Petry C, Rodriguez CA, Kronenwett R, Crespo C, Alba E, Carrasco E, Casas M, Caballero R, Rodriguez-Lescure A. Clinical validation of the EndoPredict test in node-positive, chemotherapy-treated ER+/HER2- breast cancer patients: results from the GEICAM 9906 trial. Breast Cancer Res. 2014 Apr 12;16(2):R38

  BACKGROUND

• - Müller BM, Brase JC, Haufe F, Weber KE, Budzies J, Petry C, Prinzler J, Kronenwett R, Dietel M, Denkert C. Comparison of the RNA-based EndoPredict multigene test between core biopsies and corresponding surgical breast cancer sections. J Clin Pathol. 2012 Jul;65(7):660-2.

  BACKGROUND

• - Kronenwett R, Bohmann K, Prinzler J, Sinn BV, Haufe F, Roth C, Averdick M, Ropers T, Windbergs C, Brase JC, Weber KE, Fisch K, Müller BM, Schmidt M, Filipits M, Dubsky P, Petry C, Dietel M, Denkert C. Decentral gene expression analysis: analytical validation of the Endopredict genomic multianalyte breast cancer prognosis test. BMC Cancer. 2012 Oct 5;12:456.

  BACKGROUND

• - Fitzal F, Filipits M, Rudas M, Greil R, Dietze O, Samonigg H, Lax S, Herz W,, Dubsky P, Bartsch R, Kronenwett R, Gnant M. The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial. Br J Cancer. 2015 Apr 14;112(8):1405-10

  BACKGROUND

• - Filipits M, Rudas M, Jakesz R, Dubsky P, Fitzal F, Singer CF, Dietze O, Greil R, Jelen A, Sevelda P, Freibauer C, Müller V, Jänicke F, Schmidt M, Kölbl H, Rody, A, Kaufmann M, Schroth W, Brauch H, Schwab M, Fritz P, Weber KE, Feder IS, Hennig G, Kronenwett R, Gehrmann M, Gnant M; EP Investigators. A new molecular predictor of distant recurrence in ER-positive, HER2-negative breast cancer adds independent information to conventional clinical risk factors. Clin Cancer Res. 2011 Sep 15;17(18):6012-20.

  BACKGROUND

• - M.J. Ferguson, J.A. Dewar , Tamoxifen beyond 5 years-patients' decisions regarding entry to the aTTom trial European Journal of Cancer, 2002, 38, 1857-1859

  BACKGROUND

• - Davies Christina, Pan Hongchao, Godwin Jon, Gray Richard, Arriagada Rodrigo, Raina Vinod, Abraham Mirta, Medeiros Alencar Victor Hugo, Badran Atef, Bonfill Xavier, Bradbury Joan, Clarke Michael, Collins Rory, Davis Susan R, Delmestri Antonella, Forbes John F, Haddad Peiman, Hou Ming-Feng, Inbar Moshe, Khaled Hussein, Kielanowska Joanna, Kwan Wing-Hong, Mathew Beela S, Mittra Indraneel, Müller Bettina, Nicolucci Antonio, Peralta Octavio, Pernas Fany, Petruzelka Lubos, Pienkowski Tadeusz, Radhika Ramachandran, Rajan Balakrishnan, Rubach Maryna T, Tort Sera, Urrútia Gerard, Valentini Miriam, Wang Yaochen, Peto Richard. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet. 2013;381:805-816

  BACKGROUND

• - Dubsky P, Brase JC, Jakesz R, Rudas M, Singer CF, Greil R, Dietze O, Luisser I, Klug E, Sedivy R, Bachner M, Mayr D, Schmidt M, Gehrmann MC, Petry C, Weber KE, Fisch K, Kronenwett R, Gnant M, Filipits M; Austrian Breast and Colorectal Cancer Study Group (ABCSG). The EndoPredict score provides prognostic information on late distant metastases in ER+/HER2- breast cancer patients. Br J Cancer. 2013 Dec 10;109(12):2959-64

  BACKGROUND

• - Dubsky P, Filipits M, Jakesz R, Rudas M, Singer CF, Greil R, Dietze O, Luisser I, Klug E, Sedivy R, Bachner M, Mayr D, Schmidt M, Gehrmann MC, Petry C, Weber KE, Kronenwett R, Brase JC, Gnant M; Austrian Breast and Colorectal Cancer Study Group (ABCSG). EndoPredict improves the prognostic classification derived from common clinical guidelines in ER-positive, HER2-negative early breast cancer. Ann Oncol. 2013 Mar;24(3):640-7.

  BACKGROUND

• - Denkert C, Kronenwett R, Schlake W, Bohmann K, Penzel R, Weber KE, Höfler H, Lehmann U, Schirmacher P, Specht K, Rudas M, Kreipe HH, Schraml P, Schlake G, Bago-Horvath Z, Tiecke F, Varga Z, Moch H, Schmidt M, Prinzler J, Kerjaschki D, Sinn BV, Müller BM, Filipits M, Petry C, Dietel M. Decentral gene expressionanalysis for ER+/Her2- breast cancer: results of a proficiency testing program or the EndoPredict assay. Virchows Arch. 2012 Mar;460(3):251-9.

  BACKGROUND

• - Blank PR, Filipits M, Dubsky P, Gutzwiller F, Lux MP, Brase JC, Weber KE, Rudas M, Greil R, Loibl S, Szucs TD, Kronenwett R, Schwenkglenks M, Gnant M. Cost-effectiveness analysis of prognostic gene expression signaturebased stratification of early breast cancer patients. Pharmacoeconomics. 2015 Feb;33(2):179-90.

  BACKGROUND

• - Brewster AM, Hortobagyi GN, Broglio KR, Kau SW, Santa-Maria CA, Arun B, Buzdar, AU, Booser DJ, Valero V, Bondy M, Esteva FJ. Residual risk of breast cancer recurrence 5 years after adjuvant therapy. J Natl Cancer Inst. 2008 Aug20;100(16):1179-83

  BACKGROUND

MeSH Terms

Conditions

Breast Neoplasms

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Central Study Contacts

Jacqueline LEHMANN-CHE, MD

CONTACT

01 56 09 21 11; jacqueline.lehmann-che@aphp.fr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: OTHER
• Target Duration: 10 Years
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 23, 2026
• First Posted: February 2, 2026
• Study Start (Estimated): June 28, 2026
• Primary Completion (Estimated): June 28, 2031
• Study Completion (Estimated): June 28, 2031
• Last Updated: March 13, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)