ASCO 2023 | Survival in premenopausal HR+/HER2- breast cancer with micro-metastasis and 21-gene score

Nadeem Bilani, MD, Icahn School of Medicine at Mount Sinai, New York, NY, provides a summary of the study that investigated outcomes in premenopausal patients with HR+/HER2- breast cancer and lymph node micrometastasis based on the 21-gene OncotypeDX (ODX) recurrence scores (RS) below 26, who do not benefit from chemoendocrine therapy compared to endocrine monotherapy. The research used the National Cancer Database to analyze treatment patterns and survival outcomes in premenopausal patients with early breast cancer and micrometastasis in the lymph nodes. Of the patients aged below 50 with HR+/HER2- early breast cancer and ODX data, 6.1% had micrometastasis. The study confirmed the prognostic value of ODX in this subgroup and found that RS greater than or equal to 26 was associated with poorer overall survival. Treatment decisions for patients with micrometastasis and low RS were less clear, and while chemotherapy showed improved survival in cases with RS less than 26 involving 1-3 lymph nodes, it did not benefit node-negative or micro-metastatic disease. Prospective trials are needed to validate these findings. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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