How do you incorporate Oncotype or Mammaprint recurrence score when planning an adjuvant CDK4/6 inhibitor for high-risk early-stage HR+ breast cancer?

Oncotype DX and MammaPrint recurrence scores are not used to guide adjuvant cyclin-dependent kinase 4/6 (CDK4/6) inhibitor therapy in high-risk, early-stage, hormone receptor-positive breast cancer. However, they were used to further identify the node-negative patient population with T2 or greater t...

Limitations of Oncotype DX and MammaPrint in the CDK4/6 Era

• Historical Context: Oncotype DX and MammaPrint were validated before CDK4/6 inhibitors were approved for adjuvant use. Their utility was primarily in guiding chemotherapy decisions based on recurrence risk.
• Current Limitations:
  • Oncotype DX...

Since Oncotype Dx recurrence score was not used for eligibility to monarchE trial, I do not use it to select patients for adjuvant abemaciclib. I personally stick to criteria used on monarchE, i.e. 4 or more involved axillary lymph nodes, or one to three positive nodes and either grade 3 disease or ...