How would you approach a stage 1 HR+/HER2- pre-menopausal patient <50 years old with Oncotype DX RS of 24?
Would you offer this patient chemotherapy? What are your thoughts about OFS plus AI and avoiding chemotherapy?
Answer from: Medical Oncologist at Academic Institution
All the prior comments are very reasonable. It is hard to completely exclude a small absolute benefit from chemotherapy in this group. The trial's subset analyses aren't designed to definitively answer whether ovarian suppression or direct action of the chemo led to the observed risk reduction in &l...
Answer from: Medical Oncologist at Academic Institution
In the latest publication of TAILORx trial, integrating clinical risk (high versus low risk with low being 3 cm or less with low-grade, 2 cm or less with intermediate grade, and 1 cm or less with high grade) with OncoType recurrence score (see Sparano NEJM 2019 June 3). In women less than age 50 yea...
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Medical Oncologist at Siri Onclogy and hematology Infusion Service I agree with the last two comments. No matter what...
Answer from: Medical Oncologist at Community Practice
I want to see if others have a different interpretation of the data as I do. While the distant recurrence risk in women < 50 with low clinical risk in the whole intermediate risk score (11-25) group was low at 4.7% +/- 1%, that changes within subgroups of the intermediate risk range and subsequen...
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Medical Oncologist at Icahn School of Medicine at Mount Sinai The risk with endocrine therapy alone in the examp...
Answer from: Medical Oncologist at Academic Institution
This question raises several important issues: some of the longest discussions in most tumor boards are about cases for which treatment choice has minimal effect on outcome; clinical factors are still relevant; population-based recommendations are often difficult to apply to individuals. In thi...