Would a low or intermediate OncoType RS affect your choice of adjuvant endocrine therapy for a premenopausal woman with high clinical risk HR+ early stage disease?
Would you offer AI + OFS or tamoxifen to a woman with a grade 3 T2N0 tumor and OncoType of 15?
Answer from: Medical Oncologist at Community Practice
From TEXT and SOFT trials, patients who did not receive adjuvant chemotherapy did well and had similar outcome across treatment arms, with tamoxifen performing as well as the arms with ovarian suppression. This is an interesting observation that reflects lower risk disease, that does not need chemot...
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Answer from: Medical Oncologist at Academic Institution
The purpose of oncotype is to predict chemotherapy benefit. In secondary analysis of TAILORx, clinical risk is prognostic, but is not predictive of chemotherapy benefit. At this time, we also do not have sufficient evidence to support using genomic assays to make decisions about adjuvant endocrine t...
Answer from: Medical Oncologist at Academic Institution
I would use OS + AI in this case. An analysis of the TAILORx trial published in NEJM in June 2019 looked at the prognostic significance of clinical risk in addition to the recurrence score from an Oncotype (Sparano et al. NEJM 2019).In women under the age of 50 (most of whom were premenopausal)...