Breast cancer: ASCO guidelines include Oncotype DX recurrence score

  • Andre F & al.
  • J Clin Oncol
  • 31 May 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • New guidelines from the American Society of Clinical Oncology (ASCO) recommend that women with hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative early breast cancer (eBCa) who are >50 years may skip chemotherapy if their Oncotype DX recurrence score (RS) is in the intermediate range (11-25) or lower.
  • Women age TAILORx trial found a small benefit for this age group.

Why this matters

  • This is the first guideline to reflect results of the pivotal TAILORx trial on the use of genetic biomarkers to guide treatment decisions.

Study design

  • Expert panel was convened to review the TAILORx trial, along with related published literature.
  • Low RS was 1-10; intermediate RS was 11-25; high RS was 26-100.
  • Funding: ASCO.

Key points

  • Recommendation 1: age groups that may forego chemotherapy, but not endocrine therapy alone.
    • Patients >50 years with RS
    • Patients ≤50 years with RS
  • Recommendation 2: 
    • Patients ≤50 years with RS 16-25 may be offered chemoendocrine therapy.
  • Recommendation 3:
    • Patients of any age with RS >30 should be considered for chemoendocrine therapy.
  • Recommendation 4:
    • Patients of any age with RS 26-30 may be offered chemoendocrine therapy.

Limitations

  • No confirmation of TAILORx results.

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