Oncotype Dx Provided Prognostic Information that Guided Therapy In Early Hormone Receptor Positive Breast Cancer

  • In women with HR+, HER2-negative early breast cancer:
    • The 21-gene signature score provides prognostic information that is independent of clinicopathological features
    • A high score (on a scale of 0 to 100):
      • Indicates a higher rate of distant recurrence and is predictive of chemotherapy benefit
  • The prospective Trial Assigning Individualized Options for Treatment (TAILORx):
    • Showed that endocrine therapy alone was noninferior to adjuvant chemotherapy plus endocrine (chemoendocrine) therapy in women with:
      • HR+, HER2-negative, axillary node-negative breast cancer:
        • And a 21-gene recurrence score of 11 to 25
    • An exploratory analysis indicated:
      • Some benefit of chemotherapy in women 50 years of age or younger:
        • Who had a recurrence score of 16 to 25
      • In this analysis there was a small (~1.6%) chemotherapy benefit in distant disease-free survival for patients with recurrence score results from 16 to 20, and a modest (~6.5%) chemotherapy benefit for patients with recurrence score results from 21 to 25
  • References
    • Sparano JA, Gray RJ, Ravdin PM, Makower DF, Pritchard KI, Albain KS, et al. Clinical and genomic risk to guide the use of adjuvant therapy for breast cancer. New Engl J Med. 2019;380(25):2395-2405.
    • Sparano JA, Gray RJ, Makower DF, Pritchard KI, Albain KS, Hayes DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. New Engl J Med. 2018;379(2):111-121.

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