Breast cancer: high Oncotype DX RS score predicts NACT benefit

  • Pease AM & al.
  • Ann Surg Oncol
  • 12 Dec 2018

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

  • It is already established that a high Oncotype DX recurrence score (RS) predicts distant breast cancer (BCa) recurrence and benefit from adjuvant chemotherapy (ACT) in estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative early BCa.
  • In this cohort study, high RS may also predict benefit from neoadjuvant chemotherapy (NACT).

Why this matters

  • First study to support Oncotype DX testing to identify patients most suited for neoadjuvant chemotherapy.

Study design

  • Retrospective cohort (n=989 patients with T1-T3 ER+/HER2 BCa with RS and receipt of NACT) from the National Cancer Database.
  • RS was classified as low (30).
  • Funding: None disclosed.

Key results

  • 23.0% of cohort had low RS, 45.5% had intermediate RS, 31.5% had high RS.
  • Pathologic complete response (pCR) after NACT was attained by 4.3% of the cohort.
  • pCR after NACT was attained by 9.6% of patients with high RS and 1.6% of patients with intermediate RS.
  • High RS (vs intermediate RS) was associated with nearly 5 times the likelihood of achieving pCR after NACT (OR, 4.87; 95% CI, 2.01-11.82) in multivariate analysis.
  • Low RS (vs intermediate RS) was not associated with pCR.

Limitations

  • Retrospective, observational design.
  • Potential for unmeasured confounders.

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