Dr Jagsi on the Implications of the IDEA Trial For Patients With Breast Cancer

Reshma Jagsi, MD, DPhil, Lawrence W. Davis Professor, chair,

Department of Radiation Oncology, Emory University School of Medicine, Winship Cancer Institute, discusses the implications of the IDEA trial (NCT02400190) for patients with breast cancer.

The overarching message Jagsi wishes to convey is her immense pride in being a part of a community of researchers who have diligently prioritized centering patients' experiences. This collective effort aims to enhance the quality of care oncologists provide, ensuring equity and acknowledging the vast heterogeneity within breast cancer, she explains. This diversity presents an opportunity for oncologists to personalize treatments, tailoring them to the individual patients’ needs, Jagsi adds.

She goes on to express her gratitude to the numerous women who have participated in clinical trials, starting from the landmark studies of the 1970s comparing mastectomy with breast-conserving surgery. It's truly remarkable to contemplate the bravery of patients facing a breast cancer diagnosis who willingly allow chance to determine whether they would retain their breast, Jagsi states. Their courage has paved the way for advancements that benefit future generations of women, and their contributions to research are a gift to society, she notes.

The IDEA trial is a prospective, multicenter cohort study exploring the safety of excluding radiation therapy after breast-conserving surgery in the treatment of younger postmenopausal patients by incorporating a genomic assay alongside traditional selection criteria. From June 2015 to October 2018, 200 patients 50 to 69 years of age with stage I unifocal invasive breast cancer were enrolled across 13 collaborating sites. The trial’s primary analysis occurred 5 years after the completion of surgery for the last enrolled patient.

Results, based on a median follow-up of 5.2 years for 186 patients with at least 56 months of clinical follow-up, revealed both overall and breast cancer–specific survival rates of 100%. Additionally, the 5-year rate of freedom from any recurrence was 99% (95% CI, 96%-100%).