Development and Validation of Data-Driven Estimates of Recurrence Risk and Treatment Benefit in Early Breast Cancer.

Sparano, Joseph A · J Clin Oncol · 2025

editorial · Level V

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Abstract

In the article that accompanies this editorial, Pusztai et al describe the development and validation of a new decision aide called “<i>RSClinN+</i>” for women with ER-positive, HER2-negative breast cancer with 1–3 positive axillary nodes and an Oncotype 21-gene Recurrence Score of 0 to 25; the tool provides prognostic information for 5-year invasive disease free survival, and predictive information for chemotherapy benefit, based largely on the RxPONDER trial for development, and an independent real world cohort for validation. This new tool integrates prognostic information for recurrence (ie, age, tumor size, grade, number of positive axillary node, and 21-gene Recurrence Score), and predictive information for chemotherapy benefit provides by the Recurrence Score, facilitating individualized estimates of recurrence risk and chemotherapy benefit.