Breast Cancer Coverage from Every Angle

ASCO 2019: Can Clinical Risk Stratification Predict Chemotherapy Benefit in Early Breast Cancer?

By: Melissa E. Fryman, MS
Posted: Thursday, June 13, 2019

According to the results of the TAILORx trial, stratifying patients according to clinical risk provides additional prognostic information—but not information regarding chemotherapy benefit overall. Joseph A. Sparano, MD, of the Albert Einstein College of Medicine, and colleagues presented their findings at the 2019 American Society for Clinical Oncology (ASCO) Annual Meeting in Chicago (Abstract 503).

“Clinical risk stratification… facilitates more refined estimates of absolute [chemotherapy] benefit for women [up to age 50] with a [recurrence score of] 16 to 25,” concluded the researchers.

In the presented results of this ongoing, randomized, phase III trial, a total of 9,427 women with recurrence scores and clinical risk information were included in analysis. MINDACT criteria were used to classify tumors as either low clinical risk (defined as low-grade tumors up to to 3 cm, intermediate-grade tumors up to 2 cm, or high-grade tumors up to 1 cm) or high clinical risk.

In total, 70% and 30% of women in the study were classified as low and high clinical risk, respectively; this clinical stratification provided additional prognostic information for all recurrence score categories (0–10, 11–25, 26–100). Invasive disease–free survival rates and distant recurrence–free interval rates for patients older than age 50 were similar for patients with a recurrence score of between 11 and 25 who had or had not received chemotherapy.

For patients 50 years old or younger who had recurrence scores of between 16 and 20 and between 21 and 25, the absolute reduction in distant recurrence after chemotherapy was –0.2% versus 6.5% and 6.4% versus 8.6%, for low and high clinical risk tumors, respectively.

Disclosure: The study authors’ disclosure information may be found at

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