ESMO Breast 2022 | Can we decrease chemotherapy in LN+ premenopausal women based on genomic tests?

Nadia Harbeck, MD, PhD, Ludwig Maximilians University – Grosshadern, Munich, Germany, Provides the rationale for her argument on why chemotherapy should not be decreased in woman with node positive disease of 1-3 lymph nodes based on genomic tests alone. Indeed, the recent published ASCO guidelines do not support the use of current genomic tests on the market, including, MammaPrint, Oncotype DX and EndoPredict, to recommend against the use of chemotherapy in this patient population. Supporting evidence includes the Phase III prospective MINACT (NCT00433589) and RxPONDER (NCT01272037) clinical trials, where a benefit of chemotherapy of approximately 5% was observed in lymph node-positive premenopausal woman. The ADAPT (NCT01781338) clinical trial supports withholding chemotherapy when combining a gene expression assay with an endocrine response assessment. This interview took place at the European Society for Medical Oncology (ESMO) Breast Cancer 2022 congress in Berlin, Germany.