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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Thursday, November 10, 2022
Data from SWOG 1007, presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 172), focused on the use of radiation therapy to prevent recurrence in patients with hormone receptor–positive, HER2-negative, favorable-risk node-positive breast cancer. The results suggest that only a randomized clinical trial can answer the question of whether these favorable-risk patients can safely skip regional node irradiation.
“We’ve known for a very long time that treating regional lymph nodes with radiation in patients with node-positive breast cancer can improve locoregional recurrence rates and overall survival,” said Reshma Jagsi, MD, PhD, FASTRO, of the University of Michigan, Ann Arbor, in a SWOG press release. “But we haven’t known whether all patients with node-positive breast cancer need this or whether—especially with modern therapies and our ability to use prognostic scores—certain patients may safely forego regional node irradiation.”
Dr. Jagsi and colleagues looked at data on almost 5,000 patients who took part in the S1007 RxPONDER trial. This study randomly assigned patients with hormone receptor–positive, HER2-negative breast cancer with an OncotypeDX 21-gene recurrence score of up to 25 to either chemotherapy followed by endocrine therapy or endocrine therapy alone.
Researchers evaluated how often regional node irradiation was used in these patients and analyzed the associated patterns of locoregional recurrence and invasive disease–free survival from 1 to 5 years after a patient’s random assignment to the trial. They found that practice was almost evenly divided on the use of regional node irradiation and that rates of locoregional recurrence were quite low, even in patients who had not received regional node irradiation.
A trial is currently underway to determine whether favorable-risk patients can safely skip regional node irradiation.
Disclosure: For Dr. Jagsi‘s full disclosure, visit plan.core-apps.com.
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