Development and Validation of Data-Driven Estimates of Recurrence Risk and Treatment Benefit in Early Breast Cancer
Year: 2024
Type: article
Abstract: In the article that accompanies this editorial, Pusztai et al describe the development and validation of a new decision aide called "RSClinN+" for women with ER-positive, HER2-negative breast cancer with 1-3 positive axillary nodes and an Oncotype 21-gene Recurrence Score of 0 to 25; the tool provides prognostic information for 5-year invasive disease free survival, and predictive information for chemotherapy benefit, based largely on the RxPONDER trial for development, and an independent real world cohort for validation.This new tool integrates prognostic information for recurrence (ie, age, tumor size, grade, number of positive axillary node, and 21-gene Recurrence Score), and predictive information for chemotherapy benefit provides by the Recurrence Score, facilitating individualized estimates of recurrence risk and chemotherapy benefit. "It's tough to make predictions, especially about the future." Yogi BerraEstrogen receptor (ER) positive, HER2-neu negative breast cancer is the most common breast cancer subtype, accounting for about 70% of those presenting with potentially curable localized disease..Although regarded as biologically less aggressive and potentially lethal than other subtypes, such as HER2-neu overexpressing or triple-negative breast cancer, it accounts for about 60% of all breast cancer deaths due to its prevalence and persistent recurrence risk beyond 5 years. 1 2 Although adjuvant endocrine therapy and chemotherapy reduce the relative risk of recurrence risk by roughly one-half and one-third, respectively, the absolute benefit associated with such therapies increases as the underlying recurrence risk increases.3 Conveying accurate and understandable information about recurrence risk, and translating how relative risk reduction translates to absolute treatment benefits, are critical elements of the patient-physician encounter.Prior research has shown that most women judged adjuvant chemotherapy to be worthwhile even if survival gains were small 4 5 , although the decision making process is a complex one influenced by multiple considerations, including physician bias and patient-specific factors such as age, concern about short and long-term side effects, and impact on physical functioning and livelihood, to name a few.6 7 The 21-gene
Source: Journal of Clinical Oncology
DOI: 10.1200/jco-24-02452
Author: Joseph A. Sparano
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W4405313828