{"entity":{"id":"paper-tailorx-nejm-2018","kind":"paper","name":"TAILORx: adjuvant chemotherapy guided by the 21-gene recurrence score in hormone receptor-positive, node-negative breast cancer","aka":[],"tldr":"Women with hormone receptor-positive, HER2-negative, node-negative breast cancer and a mid-range 21-gene recurrence score did just as well with endocrine therapy alone as with chemotherapy added, sparing most of them chemotherapy.","summary":"Prospective trial of 10,273 women with hormone receptor-positive, HER2-negative, axillary node-negative breast cancer; those with a recurrence score of 11 to 25 (6,711 women) were randomised to endocrine therapy alone or chemoendocrine therapy.\n\nNine-year invasive disease-free survival was 83.3 percent with endocrine therapy against 84.3 percent with chemoendocrine therapy, meeting non-inferiority. Some benefit from chemotherapy was seen in women aged 50 or younger with scores of 16 to 25.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2018","url":"https://doi.org/10.1056/NEJMoa1804710"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/29860917/"}],"tags":[],"related":[],"cancers":["hr-positive-early-high-risk"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["tailorx"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2018,"doi":"10.1056/NEJMoa1804710","pmid":"29860917","authors":"Sparano JA, Gray RJ, Makower DF, et al.","paperType":"rct","findings":["Nine-year invasive disease-free survival 83.3 percent vs 84.3 percent for scores 11 to 25 (hazard ratio 1.08, non-inferior).","Women 50 or younger with scores 16 to 25 had some chemotherapy benefit."],"whatItMeans":"Most women with node-negative hormone receptor-positive breast cancer can safely skip chemotherapy on the basis of a genomic assay; the exception is premenopausal women with scores in the upper part of the intermediate range.","caveats":["The benefit in younger women may partly reflect chemotherapy-induced ovarian suppression.","Node-positive disease was addressed separately in RxPONDER."],"changedPractice":true,"participants":10273},"route":"/key-papers/paper-tailorx-nejm-2018/","neighbours":{"cancer":[{"id":"hr-positive-early-high-risk","kind":"cancer","name":"High-risk early HR-positive breast cancer","route":"/cancers/hr-positive-early-high-risk/"}],"trial":[{"id":"tailorx","kind":"trial","name":"TAILORx","route":"/trials/tailorx/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}