Peer-influenced content. Sources you trust. No registration required. This is HCN.

The New England Journal of Medicine21-Gene Assay to Inform Chemotherapy Benefit in Node-Positive Breast Cancer

Chemotherapy Benefits Premenopausal Women but Not Postmenopausal Women in Specific Breast Cancer Cases

A recent prospective trial has shed light on the efficacy of adjuvant chemotherapy in women with hormone-receptor–positive, HER2-negative breast cancer and one to three positive axillary lymph nodes. The study specifically examines the impact of chemotherapy on invasive disease–free survival, revealing a significant difference based on menopausal status.

HCN Medical Memo
This study underscores the importance of considering menopausal status when recommending adjuvant chemotherapy. Premenopausal women with a recurrence score of 25 or lower may benefit from chemoendocrine therapy, while postmenopausal women in similar circumstances are unlikely to see added benefit.

Study Design
  • Prospective trial involving 5083 women, 33.2% premenopausal and 66.8% postmenopausal.
  • Participants had hormone-receptor–positive, HER2-negative breast cancer with one to three positive axillary lymph nodes and a recurrence score of 25 or lower.
  • Randomly assigned to endocrine-only therapy or chemoendocrine therapy.
  • Primary objective: Determine the effect of chemotherapy on invasive disease–free survival and its relation to the recurrence score.

Approximately 70% of breast cancers are hormone-receptor positive and HER2-negative.

Key Findings
  • No chemotherapy benefit observed in postmenopausal women; 5-year invasive disease–free survival was 91.9% in the endocrine-only group and 91.3% in the chemoendocrine group.
  • Significant chemotherapy benefit in premenopausal women; 5-year invasive disease–free survival was 89.0% with endocrine-only therapy and 93.9% with chemoendocrine therapy.
  • The relative chemotherapy benefit did not increase as the recurrence score increased.

More in Breast Cancer

The Healthcare Communications Network is owned and operated by IQVIA Inc.

Click below to leave this site and continue to IQVIA’s Privacy Choices form