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Poster Display session 2

5627 - Influence of age on the indication of adjuvant chemotherapy in early breast cancer using Oncotype DX. An analysis of 240 patients treated in the Institut Catala d’Oncologia (ICO) hospitals

Date

29 Sep 2019

Session

Poster Display session 2

Presenters

Sabela Recalde

Citation

Annals of Oncology (2019) 30 (suppl_5): v55-v98. 10.1093/annonc/mdz240

Authors

S. Recalde1, V. Quiroga2, S. del barco3, C. Falo1, J. Dorca3, M. Margeli4, A. Stradella1, T. Soler5, I. Teruel García6, G. Viñas7, A. Fernandez1, R. Villanueva Vázquez8, A. Vethencourt1, M. Romeo Marin9, M. Gil-Gil1

Author affiliations

  • 1 Medical Oncology, ICO - Institut Catala d'Oncologia Hospital Duran i Reynals, 08907 - Hospitalet de Llobregat/ES
  • 2 Department Of Oncology, Catalan Institute 
of Oncology, Badalona/ES
  • 3 Medical Oncology, ICO Girona, 17007 - Girona/ES
  • 4 Medical Oncology, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona/ES
  • 5 Pathology, Hospital de Bellvitge, Hospitalet de Llobregat/ES
  • 6 Medical Oncology, Institut Catala d'Oncologia (ICO), 08025 - Barcelona/ES
  • 7 Medical Oncology Department, Catalan Institute of Oncology (ICO) and Girona Biomedical Research Institute, Girona/ES
  • 8 Medical Oncology, Institut Català d'Oncologia-Hospital Duran i Reynals, Barcelona/ES
  • 9 Medical Oncology Department, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 08916 - Badalona/ES
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Resources

Abstract 5627

Background

Benefit derived from adjuvant chemotherapy (CT) is doubtful in a high percentage of patients (pt) with hormone-receptor–positive HER2 negative early breast cancer. The 21-gene recurrence-score (RS) assay Oncotype DX, provide prognostic and predictive information. Results of the TAYLORx study have confirmed that most of patients with negative node status and RS > 25 can avoid CT without increasing their risk of relapse. However, pt < 50 years (y) and RS > 20 showed benefit with CT.

Methods

Aim: To analyse the impact of age using RS test to change the indication of adjuvant CT and the relationship between different clinical pathological factors and the RS value. We analysed 240 cases out of 251 RS test performed in the 3 ICO Centers during 2017-2018. We compared the adjuvant treatment initially planned according to institutional protocol with the treatment given after RS in the total cohort and in pt < 50 y. We performed a logistical regression analysis of pathological factors and RS.

Results

CT was indicated in all pt before knowing the RS results. Only 46 pt (19%) received CT after RS results. 14 out of 88 pt < 50 y received adjuvant CT (15%). 15 pt <50 y had a RS between 21-25, only 5 of them received CT, because in most of them, the RS was performed prior TAILORx results were published. Nowadays, all of these 15 pt would had received CT: 61/240 (25%). Clinical-pathological characteristics of the series are summarized in the Table. Of the risk factors analysed, only Ki67>25 (<0.001) and PR ≤ 20% (0.01) showed a statistically significant relationship with a higher probability of RS > 25 in a multivariate analysis.Table:

209P

Age median (range)53 (19-76) <50 y 35.1% ≥50 y 64.9%
Tumor size median15 mm
Histological gradeG1 23% G2 69.7% G3 4.4%
Progesterone receptor≤20% 21% >20% 78%
Ki67 median (p25-75)20 (13,28) ≤14 27% 14-25 41% >25% 31%
Nodal status

pN0 57%

pN1mic 15%

pN1a 27%

Conclusions

82% of pt of our series could avoid CT, however this proportion change after TAYLORx results in younger patients. Today 75% of these pt would had avoided CT. Ki67 > 25% and Progesterone Receptor ≤20% were the only pathological factors associated with an increased risk of RS > 25.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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