Andres Meraz-Brenez, Medical Oncologist at Mexican Social Security Institute, shared a post on X:
“OPTIMA is a major de-escalation signal in mostly node-positive HR+/HER2− early breast cancer.
In >4,400 pts, Prosigna/PAM50-guided chemotherapy decisions met non-inferiority vs standard chemo for 5-year IBCFS: 90.4% vs 91.5%, HR 0.99. This included premenopausal pts on OFS and pts with higher nodal burden.
However, key caveats to consider and currently unknown data that will enrich the discussion include:
- The type of chemotherapy regimen: dose-dense vs. not
- Use of adjuvant CDK4/6 inhibitors
- OFS adherence and ET extension
- pN2 event numbers: is the non-inferiority signal driven mostly by low-volume N1 disease, or is it truly safe in heavy, high-volume macrometastatic nodal burden, 4–9 nodes? Remember that RxPONDER excluded pN2 pts!
Longer follow-up. 5-year IBCFS is meaningful, but it is not OS. A median follow-up of 3.9 years is still early for luminal disease.”
Other articles featuring Andres Meraz-Brenez on OncoDaily.