Breast cancer with high RS: add-on chemo yields 93% cancer-free rate at 5 years

  • Sparano JA & al.
  • JAMA Oncol
  • 30 Sep 2019

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

  • In a secondary analysis of TAILORx, the 5-year distant recurrence-free survival was 93% in patients with early breast cancer and a high 21-gene recurrence score (RS, 26-100).
  • Patients were assigned to adjuvant chemotherapy plus endocrine therapy (ET).

Why this matters

  • Findings were better than expected based on a prior trial finding 10-year distant recurrence-free survival of 62% with tamoxifen alone and 88% with tamoxifen plus chemotherapy.
  • Findings support 21-gene score to guide use of adjuvant chemotherapy.

Study design

  • Descriptive analysis of TAILORx patients (n=1389) with high RS who were assigned adjuvant chemotherapy+ET.
  • Funding: NIH; Canadian Cancer Society Research Institute; other nonindustry funding.

Key results

  • The most common chemotherapy regimens included docetaxel/cyclophosphamide (42%), an anthracycline without a taxane (24%), an anthracycline+taxane (18%), cyclophosphamide/methotrexate/5-fluorouracil (4%), other regimens (6%), and no chemotherapy (6%).
  • The 5-year estimated rate of freedom from recurrence of breast cancer at a distant site was 93.0% (standard error [SE], 0.8%).
  • The 5-year freedom of recurrence of breast cancer at a distant and/or local-regional site was 91.0% (SE, 0.8%).
  • The 5-year invasive-disease free survival was 87.6% (SE, 1.0%).
  • The 5-year OS was 95.9% (SE, 0.6%).

Limitations

  • Lack of randomization to ET alone.