Journal Article

DKFZ-2026-02699

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png CPS + EG and Neo-Bioscore predict individual outcomes but not trial results after neoadjuvant therapy for early breast cancer.

Conforti, F. ; Nekljudova, V. ; Holtschmidt, J. ; Sala, I. ; Pagan, E. ; Solbach, C. ; Untch, M. ; Denkert, C. ; Bagnardi, V. ; Bendoni, M. ; Fasching, P. A. ; Schneeweiss, A.DKFZ* ; Lück, H.-J. ; Valenza, C. ; Viale, G. ; De Pas, T. ; van Mackelenbergh, M. ; Huober, J. ; Müller, V. ; Link, T. ; Karn, T. ; Reinisch, M. ; Marmé, F. ; Bjelic-Radisic, V. ; Schem, C. ; Hartkopf, A. ; Stickeler, E. ; Hanusch, C. ; Blohmer, J.-U. ; Fehm, T. ; Rhiem, K. ; Gelber, R. D. ; Loibl, S.

2026
Cell Press Cambridge, Mass.

Abstract: CPS + EG and Neo-Bioscore are prognostic scores estimating the risk of recurrence after neoadjuvant chemotherapy for early breast cancer, but can they predict the long-term outcomes in a clinical trial? In this study, we assessed their surrogacy values at patient level and trial level for long-term outcomes, using data from 8,359 patients across nine neoadjuvant randomized trials conducted by the German Breast Group (GBG) and AGO-B study group. We found that at the patient level, both scores were significantly associated with outcomes, but at the trial level, the associations with distant disease-free survival (DDFS), invasive disease-free survival (iDFS), and overall survival (OS) were weak for both scores (R2 range = 0.03 to 0.24, with wide confidence intervals). Thus, our findings suggest that CPS + EG and Neo-Bioscore are not reliable surrogate endpoints for predicting long-term treatment benefit in neoadjuvant trials but remain valuable for estimating individual patients' residual risk after neoadjuvant treatments and guiding subsequent treatment decisions for early breast cancer patients.

Keyword(s): CPS + EG systems ; Neo-Bioscore systems ; early breast cancer ; neoadjuvant randomized control trials ; patient-level surrogacy ; surrogate endpoints ; trial-level surrogacy

Note: #NCTZFB26# / epub

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Contributing Institute(s):

1. Koordinierungsstelle NCT Heidelberg (HD02)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 50 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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