pairingsPairing
Gene-expression assay → chemotherapy omission
A gene test on the tumour decides who can skip chemotherapy without losing protection.
TAILORx (RS ≤25, node-negative) and RxPONDER (RS ≤25, 1-3 nodes, postmenopausal) show no chemotherapy benefit; MINDACT (MammaPrint) concurs. Premenopausal women with intermediate scores still benefit, possibly via ovarian suppression.
Rationale
Proliferation and ER-related gene expression predicts chemosensitivity and prognosis better than clinicopathologic factors alone.
Evidence
Three large prospective trials (>20,000 women).