Sherry X. Yang, MD, PhD, on Breast Cancer: New Recurrence Score Data From the TAILORx Trial

Cancer recurrence has been frequently utilized as a surrogate endpoint in clinical studies, particularly in the contact genomic ISIS in several cancer types. Oncotype DX recurrence score was originally developed against distant recurrence for prognosis in estrogen receptor positive, no negative breast cancer. Primary objectives our study were to assess whether recurrence score has more prognostic weight for recurrence than survival, and to evaluate associations between recurrence score and overall survival, invasive disease-free survival, and recurrence-free interval with based on recurrence as reference in [inaudible 00:01:11] trial population. Recurrence score was associated with this recurrence-free interval, independent of other prognostic factors. However, recurrence score mid-range 11 to 25 and high-range scores 26 and greater did not provide independent information for survival prognosis in this adjuvant trial population and median follow up about eight years. High-range, but not mid-range scores was associated with invasive disease-free survival. Among 499 death events in this intention to treat population, one third were due to breast cancer, all had the DFS related events. Those including 35% breast cancer, 25% other cancers, 24% other disease and 16% unknown. It is important to note overall survival and recurrence-free interval had similar event numbers. This recurrence has less events. Overall recurrence score demonstrate the more prognostic weight for recurrence than survival. The data called for developing clinical and molecular ISIS to evaluate mortality risk and disease risk with potential to further increase overall survival, which may have impact on choice, adjuvant chemotherapy, optimal duration, endocrine therapy, and other relevant treatment.