In the CMTC, the gene expression pattern of CMTC-1 is completely opposite that of CMTC-3 and results in a distinct, intermediate CMTC-2.
To determine the clinical significance of the CMTC classification scheme, we correlated the three CMTC groups using standard pathology parameters, and the results were reproduced in a large independent validation cohort.
As shown in Table 1, by using the CMTC classifier described above, the 2,181 breast cancers were divided into three similarly sized groups: CMTC-1 (37%), CMTC-2 (28%) and CMTC-3 (35%).
Since CMTC can predict treatment outcomes better than standard surgical pathological parameters, FNABs taken for CMTC group assignment of breast cancer patients in the future may help clinicians decide which patients will benefit from neoadjuvant chemotherapy.
According to Patnaik et al. [ 18], the cases were classified as follows: 36 were G1, corresponding to well-differentiated CMTC, 29 were G2, corresponding to intermediately differentiated CMTC, and 32 were G3, corresponding to poorly differentiated CMTC.
When we applied the CMTC to 866 Her2+/tumorsors in the 2,487 validation breast cancers, 652 (75.3%) were assigned to the CMTC-3 group (Table 1).
Based on Cox proportional analyses of CMTC, receptor status and all other prognostic factors, we observed the highest hazard ratio (HR) when we compared CMTC-1 versus CMTC-3 (HR = 12.55, P <0.05), followed by IGS good versus IGS poor (HR = 11.30, P <0.05) and CMTC-1 versus CMTC-2 plus CMTC-3 (HR = 8.79, P <0.05) in the 284 breast cancers from the new internal cohort.
However, the soluble fluconazole loaded gel formulation of CMTC showed diffusion based kinetic model indicating good reservoir for effective application on skin/tissue surfaces.
We observed the same pattern of clinical outcome among the CMTC groups (better in CMTC-1 and worse in CMTC-2 and CMTC-3) across all three platforms.
Further validation of CMTC requires prospective, randomized, controlled trials.
