Trial reportThe American journal of pathology2010
Multiplexed assessment of the Southwest Oncology Group-directed Intergroup Breast Cancer Trial S9313 by AQUA shows that both high and low levels of HER2 are associated with poor outcome.
Trial report in The American journal of pathology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Higher ER load is not associated with better outcome in stage 1-3 breast cancer: a descriptive overview of quantitative HR analysis in operable breast cancer.Breast cancer research and treatment · 2019Pooled it
- ER and HER2 expression are positively correlated in HER2 non-overexpressing breast cancer.Breast cancer research : BCR · 2012Trial
- Advances in Targeting HER2 across Cancer Subtypes: A Pan-Tumor Approach.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Review
- HER2 expression in breast cancer: evidence gaps and challenges.NPJ precision oncology · 2025Review
- Machine Learning for Digital Scoring of PRMT6 in Immunohistochemical Labeled Lung Cancer.Cancers · 2023Article
- The HER2-low revolution in breast oncology: steps forward and emerging challenges.Therapeutic advances in medical oncology · 2023Review
- Expanding the reach of HER2-targeted therapies: transformation of an historical paradigm.The Journal of clinical investigation · 2022Article
- Tumor-associated macrophage, angiogenesis and lymphangiogenesis markers predict prognosis of non-small cell lung cancer patients.Journal of translational medicine · 2020Article
- Spatially multiplexed RNA in situ hybridization to reveal tumor heterogeneity.Nucleic acids research · 2020Article
- Internodal HER2 heterogeneity of axillary lymph node metastases in breast cancer patients.Bosnian journal of basic medical sciences · 2019Article
- Article
- Breast Cancer Staging: Is TNM Ready to Evolve?Journal of global oncology · 2018Article
- A novel quantitative immunohistochemistry method for precise protein measurements directly in formalin-fixed, paraffin-embedded specimens: analytical performance measuring HER2.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2017Article
- Quantitative comparison and reproducibility of pathologist scoring and digital image analysis of estrogen receptor β2 immunohistochemistry in prostate cancer.Diagnostic pathology · 2016Article
- Image analysis of immunohistochemistry is superior to visual scoring as shown for patient outcome of esophageal adenocarcinoma.Histochemistry and cell biology · 2015Article
- Quantitative comparison of immunohistochemical staining measured by digital image analysis versus pathologist visual scoring.Diagnostic pathology · 2012Article
- Novel staging system for predicting disease-specific survival in patients with breast cancer treated with surgery as the first intervention: time to modify the current American Joint Committee on Cancer staging system.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2011Article
- Standardization of estrogen receptor measurement in breast cancer suggests false-negative results are a function of threshold intensity rather than percentage of positive cells.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
Assessment of key breast cancer tissue biomarkers is often done using nonquantitative methods. We hypothesized that use of continuous analysis of expression with the AQUA method of automated quantitative analysis will provide prognostic information beyond that attainable with conventional methods. A tissue microarray was made from 2123 of 3122 patients accrued to SWOG 9313, in which sequential doxorubicin (A) and cyclophosphamide (C) was compared with combination AC and in which all patients except premenopausal estrogen receptor (ER)-negative patients received tamoxifen. Multiplexed assays of 1) HER2 and estrogen receptor and 2) progesterone receptor (PgR) and p53 were performed on the two slides using the immunofluorescence-based AQUA method of automated quantitative analysis. Both ER and PgR showed unimodal distributions and significantly predicted disease-free survival when tested as continuous variables and adjusted for node status, tumor size, treatment, and menopausal status (P = 0.005 and P < 0.001, respectively). HER2, measured as a continuous variable, showed a biphasic effect on disease-free survival. Both high and low expressers of HER2 have worse outcomes (when low levels are equivalent to that seen in normal breast ducts). In patients who were uniformly treated with AC chemotherapy and tamoxifen (when indicated), both ER and PgR, assessed as continuous variables, were highly prognostic, whereas p53 expression was not. This assay method may provide a new companion diagnostic approach for targeted therapies.
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