Sergio Cifuentes Canaval, Medical Oncologist at Las Américas Auna Clinic, shared a post on LinkedIn:
“Anthracyclines in Early HR+/HER2− Breast Cancer: Still a Role?
Recent data comparing EC-T (anthracycline-based) vs TC (anthracycline-sparing) chemotherapy across Oncotype DX Recurrence Score (RS) subgroups provide important perspective for daily practice.
Key observations:
- Across RS ≤25, RS 26–30, and RS ≥31, there were no statistically significant differences in DRFS, iDFS, or OSbetween EC-T and TC.
- No treatment-by-RS interaction was observed, suggesting RS alone does not clearly identify a subgroup deriving consistent survival benefit from anthracyclines.
- Event numbers remain low, and confidence intervals are wide-highlighting the challenge of detecting modest benefits in contemporary, genomically selected populations.
Clinical interpretation:
These data reinforce that anthracycline benefit is not universal, particularly in HR+/HER2− disease guided by genomic risk.
However, the signal does not fully exclude benefit in selected higher-risk patients (e.g., very high RS, adverse clinicopathologic features).
The decision to include anthracyclines should remain individualized, balancing:
Absolute risk reduction
- Long-term toxicities (cardiac, leukemia)
- Patient comorbidities and preferences
Take-home message:
Anthracyclines are no longer ‘one size fits all’ but they are not obsolete. Careful patient selection—beyond RS alone—remains essential.
These discussions continue to reshape how we optimize efficacy while minimizing long-term harm in early breast cancer.”
Title: A tale of two trials: TAILORx and PlanB. Letter to the Editor regarding ‘Impact of anthracyclines in genomic high-risk, node-negative, HR-positive/ HER2-negative breast cancer’ by Chen et al.
Authors: Oleg Gluz, Ronald Kates, Sherko Kuemmel, Ulrike Nitz, Nadia Harbeck
Read the full article on ESMO Annals of Oncology
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