Where does the OPTIMA trial, presented at ASCO 2026, fit into decision-making for chemotherapy for premenopausal women with high clinical and low genomic risk ER+ breast cancer?
Do you favor this approach over Oncotype DX for node-positive patients per RxPONDER?
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Will you use a genomic assay to determine whether to recommend chemotherapy to pre-menopausal female patients with pN2 ER+ breast cancer?
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2 Answers
Mednet MemberInvited Expert
Medical Oncology · Ohio State University
Answered on
Since the median follow-up on this trial was only 4 years (which is considered short for patients with operable, hormone receptor-positive, HER2-negative breast cancer) and since the study has not yet been published in a peer-reviewed journal, I would exercise extreme caution in skipping potentially...
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Mednet MemberInvited Expert
Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
Answered on
For premenopausal patients with pN2/pN3, the current guideline recommendation is adjuvant chemotherapy followed by endocrine therapy ± ovarian suppression/ablation (category 1), with no genomic assay step in the decision pathway. No genomic assay is validated yet.
The OPTIMA trial presented at ASCO ...
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