TY - JOUR
T1 - Use of biomarkers to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer
T2 - ASCO clinical practice guideline update-integration of results from TAILORx
AU - Andre, Fabrice
AU - Ismaila, Nofisat
AU - Henry, N. Lynn
AU - Somerfield, Mark R.
AU - Bast, Robert C.
AU - Barlow, William
AU - Collyar, Deborah E.
AU - Hammond, M. Elizabeth
AU - Kuderer, Nicole M.
AU - Liu, Minetta C.
AU - Van Poznak, Catherine
AU - Wolff, Antonio C.
AU - Stearns, Vered
N1 - Publisher Copyright:
© 2019 American Society of Clinical Oncology.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - PURPOSE This focused update addresses the use of Oncotype DX in guiding decisions on the use of adjuvant systemic therapy. METHODS ASCO uses a signals approach to facilitate guideline updating. For this focused update, the publication of the Trial Assigning Individualized Options for Treatment (TAILORx) evaluating noninferiority of endocrine therapy alone versus chemoendocrine therapy for invasive disease-free survival in women with Oncotype DX scores provided a signal. An expert panel reviewed the results of TAILORx along with other published literature on the Oncotype DX assay to assess for evidence of clinical utility. UPDATED RECOMMENDATIONS For patients with hormone receptor-positive, axillary node-negative breast cancer whose tumors have Oncotype DX recurrence scores of less than 26, there is little to no benefit from chemotherapy, especially for patients older than age 50 years. Clinicians may recommend endocrine therapy alone for women older than age 50 years. For patients 50 years of age or younger with recurrence scores of 16 to 25, clinicians may offer chemoendocrine therapy. Patients with recurrence scores greater than 30 should be considered candidates for chemoendocrine therapy. Based on informal consensus, the panel recommends that oncologists may offer chemoendocrine therapy to these patients with recurrence scores of 26 to 30. Additional information can be found at www.asco.org/breast-cancer-guidelines.
AB - PURPOSE This focused update addresses the use of Oncotype DX in guiding decisions on the use of adjuvant systemic therapy. METHODS ASCO uses a signals approach to facilitate guideline updating. For this focused update, the publication of the Trial Assigning Individualized Options for Treatment (TAILORx) evaluating noninferiority of endocrine therapy alone versus chemoendocrine therapy for invasive disease-free survival in women with Oncotype DX scores provided a signal. An expert panel reviewed the results of TAILORx along with other published literature on the Oncotype DX assay to assess for evidence of clinical utility. UPDATED RECOMMENDATIONS For patients with hormone receptor-positive, axillary node-negative breast cancer whose tumors have Oncotype DX recurrence scores of less than 26, there is little to no benefit from chemotherapy, especially for patients older than age 50 years. Clinicians may recommend endocrine therapy alone for women older than age 50 years. For patients 50 years of age or younger with recurrence scores of 16 to 25, clinicians may offer chemoendocrine therapy. Patients with recurrence scores greater than 30 should be considered candidates for chemoendocrine therapy. Based on informal consensus, the panel recommends that oncologists may offer chemoendocrine therapy to these patients with recurrence scores of 26 to 30. Additional information can be found at www.asco.org/breast-cancer-guidelines.
UR - http://www.scopus.com/inward/record.url?scp=85070788790&partnerID=8YFLogxK
U2 - 10.1200/JCO.19.00945
DO - 10.1200/JCO.19.00945
M3 - Review article
C2 - 31150316
AN - SCOPUS:85070788790
SN - 0732-183X
VL - 37
SP - 1956
EP - 1964
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 22
ER -