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70-gene signature as an aid for treatment decisions in early breast cancer: updated results of the phase 3 randomised MINDACT trial with an exploratory analysis by age

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70-gene signature as an aid for treatment decisions in early breast cancer: updated results of the phase 3 randomised MINDACT trial with an exploratory analysis by age

The Lancet Oncology

Fecha de publicación: 1 de abril de2021

DOI: https://doi.org/10.1016/S1470-2045(21)00007-3

Autores: Prof Martine Piccart, MD  *, Prof Laura J van ‘t Veer, PhD *, Coralie Poncet, MSc *, Josephine M N Lopes Cardozo, MD, Suzette Delaloge, MD, Jean-Yves Pierga, MD, Peter Vuylsteke, MD, Prof Etienne Brain, MD, Suzan Vrijaldenhoven, MD, Peter A Neijenhuis, MD, Sylvian Causeret, MD, Tineke J Smilde, MD, Prof Giuseppe Viale, MD, Annuska M Glas, PhD, Mauro Delorenzi, PhD, Prof Christos Sotiriou, MD,Prof Isabel T Rubio, MD, Prof Sherko Kümmel, MD, Prof Gabriele Zoppoli, MD, Prof Alastair M Thompson, MD, Erika Matos, MD, Khalil Zaman, MD, Florentine Hilbers, MSc, Debora Fumagalli, MD, Peter Ravdin, MD, Susan Knox, MA, Konstantinos Tryfonidis, MD, Aleksandra Peric, PhD, Bart Meulemans, MSc,Jan Bogaerts, PhD, Fatima Cardoso, MD , Prof Emiel J T Rutgers, MD 

Background: The MINDACT trial showed excellent 5-year distant metastasis-free survival of 94·7% (95% CI 92·5–96·2) in patients with breast cancer of high clinical and low genomic risk who did not receive chemotherapy. We present long-term follow-up results together with an exploratory analysis by age. Methods: MINDACT was a multicentre, randomised, phase 3 trial done in 112 academic and community hospitals in nine European countries. Patients aged 18–70 years, with histologically confirmed primary invasive breast cancer (stage T1, T2, or operable T3) with up to three positive lymph nodes, no distant metastases, and a WHO performance status of 0–1 were enrolled and their genomic risk (using the MammaPrint 70-gene signature) and clinical risk (using a modified version of Adjuvant! Online) were determined. Patients with low clinical and low genomic risk results did not receive chemotherapy, and patients with high clinical and high genomic risk did receive chemotherapy (mostly anthracycline-based or taxane-based, or a combination thereof).

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