Better Together: Clinical and Genomic Data to Inform Shared Decision Making
Menée à partir de données portant sur 10 004 patientes atteintes d'un cancer du sein HR+ HER2- de stade précoce et sans envahissement ganglionnaire puis validée à partir de données portant sur 1 098 patientes supplémentaires, cette étude évalue la performance d'un outil, intégrant des données génomiques (expression de 21 gènes) et des données clinicopathologiques, pour établir un pronostic et identifier les patientes pouvant bénéficier d'une chimiothérapie adjuvante
For over 20 years, the uncertainty of absolute benefit of adjuvant therapy among patients with nonmetastatic breast cancer has resulted in the development of tools to quantitatively estimate the risk of recurrence and benefit of endocrine and chemotherapy. Several computer-based decision support tools have been developed to assist providers in communicating with patients to enhance shared decision making, and the most notable has been adjuvant.1 The original program used age, menopausal status, hormone receptor status, tumor size, and number of nodes to calculate risks using estimates from breast cancer clinical trials and meta-analyses. The tool calculates the 10-year prognosis and the absolute benefit of endocrine therapy and chemotherapy in terms of death from cancer and overall mortality. The authors of the original manuscript noted that the development of the computer program represented an evolutionary process that would change over time as estimates of risk and benefit improve.
Journal of Clinical Oncology , éditorial en libre accès, 2019