ASCO 2021 | PREDICT+ underestimates survival of patients with HER2+ early breast cancer

Elisa Agostinetto, MD, Istituto Clinico Humanitas, Rozzano, Milan, Italy, discusses an analysis of the prognostic performance of PREDICT+ in patients with HER2-positive (HER2+) early-stage breast cancer (EBC). PREDICT+ is a widely used online tool, designed to predict mortality in EBC and guide adjuvant treatment decisions. To better understand the prognostic role of PREDICT+ in patients with HER2+ EBC, patients who received chemotherapy and anti-HER2 therapy in the Phase III ALTTO trial (NCT00490139) were analyzed. Estimated survival using PREDICT+ was compared to observed survival for 2794 patients. The analysis showed that PREDICT+ underestimated 5-year overall survival by 6.7%. This finding was consistent across all subgroups, with the greatest underestimation in patients with hormone receptor-negative disease, node-positive disease, or larger tumor size. Dr Agostinetto discusses why these findings may have occurred and what they mean for the use of PREDICT+ for prognostic estimation in this patient population. This interview took place at the American Society of Clinical Oncology (ASCO) 2021 Virtual Meeting.