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Neelima Denduluri, MD, discusses the use of the Oncotype DX assay in early-stage hormone receptor–positive, HER2-negative breast cancer.
Neelima Denduluri, MD, medical oncologist, Virginia Cancer Specialists, discusses the use of the Oncotype DX assay in early-stage hormone receptor—positive, HER2-negative breast cancer.
Oncotype DX can help identify which patients need chemotherapy in addition to endocrine therapy as well as those who can be spared the toxicities associated with chemotherapy, explains Denduluri. For example, data from the phase III TAILORx trial demonstrated that women with node-negative, HR-positive, HER2-negative disease who have a low Oncotype DX recurrence score can safely avoid chemotherapy. These data can also be applied to men with breast cancer, says Denduluri. Additionally, patients with low-risk, node-positive disease have a good prognosis and may not need chemotherapy.
However, clinical risk should be considered in conjunction with genomic risk, particularly for patients with an intermediate recurrence score, says Denduluri. For example, patients under the age of 50 who may not have gone through menopause need escalated therapy, whether it’s with a second modality of endocrine therapy or chemotherapy, concludes Denduluri.