Prospective Validation of 21-Gene Risk of Recurrence Score
(HealthDay News) — A 21-gene risk of recurrence score can identify patients with breast cancer who may be spared chemotherapy, according to a study published online September 28 in the New England Journal of Medicine to coincide with the 2015 European Cancer Congress, held from September 25–29 in Vienna.
Joseph A. Sparano, MD, from the Montefiore Medical Center in Bronx, NY, and colleagues conducted a prospective trial involving 10,253 women with hormone-receptor-positive, human epidermal growth factor receptor type 2 (HER2)-negative, axillary node-negative breast cancer. A reverse transcriptase-polymerase chain reaction assay of 21 genes was performed on tumor tissue and the results were used to calculate a score indicating the risk of recurrence. Patients with a recurrence score of 0 to 10 (low risk of recurrence) were assigned to receive endocrine therapy without chemotherapy.
The researchers found that 15.9% of participants had a recurrence score of 0 to 10 and received endocrine therapy without chemotherapy. In this patient population, the rates of invasive disease-free survival, freedom from recurrence from breast cancer at a distant site, freedom from recurrence of breast cancer at a distant or local-regional site, and overall survival were 93.8, 99.3, 98.7, and 98.0%, respectively, at five years.
"This prospective study involving uniformly treated patients with hormone-receptor positive, HER2-negative, axillary node-negative breast cancer supports the clinical validity of the 21-gene assay in identifying patients who may be safely spared adjuvant chemotherapy," the authors write.