MINDACT Trial of Adjuvant Chemotherapy for Early Luminal Breast Cancer: Does Age Matter?
Posted: Tuesday, March 10, 2020
According to an analysis of the MINDACT trial, women between the ages of 40 and 50, with hormone receptor–positive or HER2-negative breast cancer who have a high clinical risk and a low genomic risk might be undertreated with tamoxifen alone. These findings were presented at the 2019 San Antonio Breast Cancer Symposium (Abstract GS4-05) by Fatima Cardoso, MD, of the Champalimaud Clinical Center in Lisbon, Portugal, and colleagues, who noted that the added value of chemotherapy along with endocrine therapy should be studied further.
“Similar to the TAILORx trial, we found that women classified as high risk of recurrence by traditional clinical-pathological factors but low risk by MammaPrint had a worse outcome if treated with tamoxifen alone, and that the benefit of chemotherapy may eventually be higher in this group,” shared Dr. Cardoso in an American Association for Cancer Research press release.
Researchers focused on 1,264 patients (81.7% of whom had luminal breast cancers); 399 patients were between the ages of 40 and 50, and 865 patients were 50 years of age or older. The average tumor size was 2.2 cm in both age groups, half the patients had a negative nodal status, and the majority had grade 2 or 3 tumors.
The 5-year distant metastasis–free survival among the patients older than 50 who received chemotherapy was 95.2% versus 95.4% who did not. In patients between ages 40 and 50, the estimated distant metastasis–free survival for those who received chemotherapy was 96.2% versus 92.5% for those who did not receive chemotherapy.
“These findings, while hypothesis-generating, are not yet practice-changing as they require confirmation. However, our results and the TAILORx trial results seem to indicate that younger women with high clinical risk and low genomic risk (per MammaPrint) or with an intermediate recurrence score (per Oncotype DX) may benefit from additional treatment,” noted Dr Cardoso.
Disclosure: The study authors’ disclosure information can be found at abstractsonline.com.
