How are you approaching intermediate Oncotype in elderly patients, especially in discussion of avoiding chemotherapy and using adjuvant CDK 4/6 inhibitors?
For example, if a post-menopausal elderly woman has a small focus of node positive disease, would one consider adjuvant abemaciclib + endocrine therapy (in light of MonarchE, 2020 Johnston et al. and 2021 update Harbeck et al.)
Answer from: Medical Oncologist at Community Practice
monarchE used adjuvant chemotherapy.Thereafter, Abemaciclib with hormone therapy.
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Answer from: Medical Oncologist at Community Practice
The woman in question most likely will not receive chemotherapy. Oncotype does not give guidance over the use of CDKi, only chemotherapy. The patient does not meet the criteria for the monarchE study. She would be considered high risk unless she met other criteria. The majority of the patients in mo...