A secondary analysis of the IDEAL phase 3 randomized clinical trial, published in JAMA Network Open, confirms that the MammaPrint genomic test can predict the benefit of extended endocrine therapy (EET) in postmenopausal women with hormone receptor-positive (HR+) early-stage breast cancer. This reinforces previous findings from the NSABP B-42 trial, demonstrating MammaPrint’s ability to identify patients most likely to benefit from extended endocrine therapy and those who might safely avoid it and its associated side effects. The study focused on MammaPrint’s predictive ability regarding EET in preventing late recurrences among a cohort of 515 postmenopausal patients with early-stage HR+ breast cancer from the IDEAL trial.
This addresses a critical challenge in breast cancer treatment: determining the optimal duration of endocrine therapy. While extended endocrine therapy can reduce the risk of late recurrence, it can also cause unnecessary side effects for some patients. By identifying which patients are most likely to benefit from extended therapy, MammaPrint offers a personalized approach, potentially improving long-term outcomes and quality of life for those affected by breast cancer. This precision medicine approach moves beyond traditional clinical risk factors to provide a more tailored and effective treatment strategy.
The study involved patients who were randomized to receive either 2.5 or 5 years of letrozole after completing 5 years of initial endocrine therapy. The original IDEAL trial found no overall benefit from 5 years versus 2.5 years of extended therapy. However, using MammaPrint genomic profiling, researchers identified a subset of patients who did benefit from EET. The data indicates MammaPrint accurately predicted which patients with low genomic risk would experience improved recurrence-free survival with extended endocrine therapy. Conversely, the test also identified patients at high genomic risk who derived minimal benefit from extended treatment, allowing them to potentially avoid unnecessary side effects.
This validation of MammaPrint’s predictive ability has significant implications for the field of personalized oncology. It extends the clinical utility of MammaPrint beyond guiding chemotherapy decisions and into optimizing the duration of adjuvant endocrine therapy. This personalized approach promises to improve patient outcomes by maximizing treatment efficacy while minimizing exposure to unnecessary therapies and associated side effects, ultimately leading to a higher quality of life for those diagnosed with early-stage breast cancer.
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Jon Napitupulu is Director of Media Relations at The Clinical Trial Vanguard. Jon, a computer data scientist, focuses on the latest clinical trial industry news and trends.
