Updated ASCO Clinical Practice Guideline Integrates TAILORx Trial Results in Breast Cancer
Posted: Monday, July 22, 2019
Based on new findings from the TAILORx clinical trial, the American Society of Clinical Oncology (ASCO) Clinical Practice Guideline has been updated to include recommendations on the use of biomarkers to guide adjuvant therapy for early-stage invasive breast cancer and published them in the Journal of Clinical Oncology. Fabrice Andre, MD, PhD, of the Institute Gustave Roussy and Paris Sud University, Paris, and colleagues addressed the use of Oncotype DX breast cancer recurrence scores in guiding decision-making for patients and physicians when using adjuvant systematic therapy.
“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,” the authors concluded, among other recommendations.
This systematic review-based guideline is conducted by a multidisciplinary Expert Panel and centered on the recent findings from the TAILORx trial, which measured the noninferiority of endocrine therapy alone versus chemoendocrine therapy for invasive disease–free survival in women with intermediate Oncotype DX scores. That study included 6,711 women with hormone receptor–positive, HER2-negative, axillary node–negative breast cancer who had Oncotype DX scores between 11 and 25.
As a result, the ASCO panel recommended that physicians propose endocrine therapy alone for women 50 years old or younger and who have recurrence scores from 16 to 25. Additionally, patients with scores over 30 should be considered for chemoendocrine therapy alone. Finally, oncologists may endorse chemoendocrine therapy in cases where patients have Oncotype DX scores between 26 and 30.
“The biomarker testing Expert Panel will review the pertinent literature on the use of Oncotype DX in women with node-positive breast cancer in the coming months to address perceived practice variation regarding the use of this biomarker test in this population of women with breast cancer,” the authors added.
Disclosure: The authors’ disclosure information can be found at ascopubs.org.