High Recurrence Score® result correlates with greater benefit from chemotherapy (NSABP B-20)
{"Image DocumentName": "High Recurrence Score\u00ae result correlates with greater benefit from chemotherapy (NSABP B-20)", "Image ImageDescription": "Patients with high RS. 28% absolute benefit from tamoxifen + chemotherapy Proportion without distant recurrence N. Events. All patients. Tamoxifen + chemotherapy. Tamoxifen P = N. Events. 4.4% absolute benefit from tamoxifen + chemotherapy RS < 18. Tamoxifen + chemotherapy. Tamoxifen P = Main point: The Recurrence Score\u00ae result shows that not all patients benefit equally from chemotherapy. These results recapitulate the seminal findings from the original B-20 study (Fisher B, Dignam J, Wolmark N, et al. J Natl Cancer Inst.1997;89: ), which supported the widespread use of adjuvant cytotoxic therapy for this population. The absolute benefit of chemotherapy at 10 years is 4.4%. Is this small overall benefit due to a little benefit in many or most of the patients, or is this small benefit due to a large benefit in a subset of the patients? To address this question, the magnitude of the chemotherapy benefit was examined for each of the Recurrence Score risk groups, showing that not all women benefit equally from chemotherapy. It appears that much of the benefit associated with CMF therapy in the B-20 study was a function of the risk reduction experienced by this high-risk cohort, which represents approximately 25% of the population. The high-risk patients have a large benefit (28% absolute) from the addition of chemotherapy. Patients in the low-risk group (Recurrence Score value <18) have a very low likelihood of distant recurrence. The difference between the tamoxifen alone and tamoxifen plus chemotherapy groups is not statistically significant, so the benefit of chemotherapy appears to be minimal, if any. Patients in the intermediate-risk group (Recurrence Score value 18-30), as expected, had a higher risk of distant recurrence than those in the low-risk group. The benefit of chemotherapy in the intermediate-risk patients does not appear to be large. Paik S, et al. J Clin Oncol. 2006;24: RS Tamoxifen + chemotherapy. Tamoxifen P = RS \u2265 31. Tamoxifen + chemotherapy. Tamoxifen P < Years. RS, Recurrence Score result. Paik S, et al. J Clin Oncol. 2006;24:", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}