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Top Line: Which women benefit most from adjuvant chemoendocrine therapy versus endocrine therapy alone?

The Study: The 21-gene recurrence score plays an important role in identifying patients who benefit from adjuvant chemotherapy (or more often those who have less benefit from endocrine therapy alone). But we’ve learned from studies like TAILORx that the RS-predicted benefit of chemotherapy may vary depending on other clinicopathologic factors. RSClin is a useful tool that provides better prediction than the RS alone. However, you’ve got to log into your OncotypeDX account to access it. Here is an industry-independent clinical decision tool, called BTxCHOICE (no, it’s not a bitcoin ETF), that predicts 10-year distant recurrence risk and life years gained with chemoendocrine therapy. It uses age, tumor size, tumor grade, and comorbidity level. In addition, it can be used with or without a RS. In addition, BTxCHOICE can also be used to estimate a range of probable RS’s for a given clinical scenario. For example, it can be used for a woman aged 40-44 with a T1, intermediate grade tumor to estimate an 11% chance of having a RS > 25 and a predicted (minus the RS) 2.6% reduction in her risk of 10-year distant recurrence with chemoendocrine therapy. When the RS is available, it can then provide a more accurate estimate of risk reduction. The only problem is that we had trouble finding a BTxCHOICE website.

TBL: BTxCHOICE is a web-based decision tool to help inform patients and clinicians about the benefits of chemoendocrine therapy versus endocrine therapy alone for early stage, ER+ breast cancer. | Jayasekera, J Clin Oncol 2021

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