Predicting Expected Absolute Chemotherapy Treatment Benefit in Women With Early-Stage Breast Cancer Using EndoPredict, an Integrated 12-Gene Clinicomolecular Assay.

PURPOSE: Previous studies have shown EndoPredict (EPclin), a test that integrates 12-gene expression data with nodal status and tumor size, to be predictive for risk of distant recurrence in women with estrogen receptor-positive, human epidermal growth factor receptor 2-negative early-stage breast cancer. Here, we modeled expected absolute chemotherapy benefit on the basis of EPclin test results. METHODS: The effect of chemotherapy was modeled using previously validated 10-year risk of distant recurrence as a function of EPclin score for patients treated without chemotherapy. Average relative chemotherapy benefit to reduce breast cancer distant recurrence was evaluated using a published meta-analysis from the Early Breast Cancer Trialists' Collaborative Group. Absolute chemotherapy benefit differences were estimated across a range of interaction strengths between relative chemotherapy benefit and EPclin score. The average absolute benefit was calculated for patients with high and low EPclin scores using the distribution of scores in 2,185 samples tested by Myriad Genetics. RESULTS: The average expected absolute benefit of chemotherapy treatment for patients with a low EPclin score was 1.8% in the absence of interaction and 1.5% for maximal interaction. Conversely, the expected average absolute chemotherapy benefit for patients with a high EPclin score was 5.3% and 7.3% for no interaction and maximal interaction, respectively. CONCLUSION: For women with estrogen receptor-positive, human epidermal growth factor receptor 2-negative early-stage breast cancer, a high EPclin score identified which patients would benefit most from adjuvant chemotherapy in terms of absolute reduction of distant recurrence, regardless of the amount of interaction between EPclin and relative chemotherapy benefit. A high degree of prognostic discrimination for distant recurrence is more important for identifying patients likely to benefit most from chemotherapy than an interaction between EPclin and treatment-relative benefit

Call playback artificially generates a temporary cultural style of high affiliation in marmosets

Cultural variation can be conceptualised in two main ways: as culture-specific qualitative differences in behavioural form, and also as quantitative variation in performance of constellations of universal behaviours (cultural style). Despite observation of both types in wild non-human primates, diffusion of qualitative culture has been scrutinised extensively experimentally whilst within-species transmission of cultural style has remained entirely unexplored. Here we investigated whether a cultural style of high affiliation could be artificially generated in a nonhuman primate (Callithrix jacchus), by daily playback of conspecific affiliative calls simulating nearby amicable individuals. We found that vocalisation playback influenced monkeys to spend more time in affiliative behaviours outwith playback hours, relative to silent playback. The effect was specific to affiliation, with no impact on other categories of affect. This change did not persist into the final phase of observation after all playbacks were complete. Findings are consistent with a temporary shift in cultural style effected through vocalisation playback, supporting existence of this conception of culture in wild primates and indicating auditory social contagion as a potential diffusion mechanism. The method presented here will allow researchers to test hypotheses concerning cultural transmission of cultural style, and the underlying processes, across a range of contexts and species