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Diogo Alpuim Costa/oxyclinic.pt

Diogo Alpuim Costa, Head of the Oncology Department and Medical Day Hospital at Cascais Hospital, Dr. José de Almeida, and Clinical Director at Cascais Hyperbaric Center, shared a post on LinkedIn about a paper he co-authored with colleagues published in Clinical Breast Cancer:

“Honoured to be part of this fantastic Portuguese group led by Dr. Teresa Padrão and Prof. José Luis Passos Coelho, which allowed us to assess the Portuguese landscape using a 21-Gene Recurrence Score Assay to guide adjuvant treatment decisions in over 1000 patients with hormone receptor–positive (HR+), HER2- Early Breast Cancer.

Published in Clinical Breast Cancer.

The key messages of the paper ‘The Use and Impact on Treatment Decision of the 21-Gene Recurrence Score Assay for Patients With HR/HER2– Early Breast Cancer in Portugal: A Nationwide Retrospective Cohort Study’ are:

• The 21-gene Recurrence Score Assay (Oncotype DX) was widely adopted in Portugal and had a substantial impact on adjuvant chemotherapy decisions in hormone receptor-positive, HER2-negative early breast cancer patients, aligning treatment practice with international pivotal trials.
• After the publication of the TAILORx trial, adjuvant chemotherapy use decreased in patients with Recurrence Score (RS) ≤16 and increased in those with RS ≥25, especially among younger patients.
• Progesterone receptor (PR) and Ki-67 were independent predictors of high recurrence scores (RS ≥25), supporting the use of these markers to more selectively apply the 21-gene assay in resource-limited clinical settings.
• The Johns Hopkins Recurrence Score Estimator (JHRE) showed moderate accuracy (53.6%) and low specificity (47.7%) in predicting high-risk scores, suggesting its limited utility for individual decision-making in clinical practice.
• Chemotherapy was appropriately avoided in low-risk groups and escalated in high-risk groups following the influence of real-world pivotal trial results, confirming the clinical value of the assay for individualized patient care in Portugal.
• Recurrence rates were low (2.3% median follow-up 29 months), reflecting careful patient selection for chemotherapy de-escalation using the assay.
• Real-world national data, such as this study, are essential for guiding clinical decision-making, health policy, and the cost-effective use of genomic tests in routine oncology practice.”

Title: The Use and Impact on Treatment Decision of the 21-Gene Recurrence Score Assay for Patients With HR+/HER2− Early Breast Cancer in Portugal: A Nationwide Retrospective Cohort Study

Authors: Teresa Gantes Padrão, Diana Pessoa, Joana Alves Luís, Diogo Alpuim Costa, Mário Fontes e Sousa, Ídilia Pina, Susana Palma de Sousa, Débora Cardoso, Sandra Bento, Joana Simões, Ana Ferreira, Renato Cunha, Diogo Martins-Branco, Tiago Dias Domingues, and José Luís Passos-Coelho

You can read the Full Article in Clinical Breast Cancer.

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