An online tool (RSClin) incorporating clinical-pathologic data and results of the 21-gene recurrent score (RS) successfully estimated distant recurrence (DR) risk and adjuvant chemotherapy benefit in women with hormone receptor-positive, HER2-, and node-negative breast cancer according to a study for which researchers developed and tested the tool in 10,004 women who received endocrine therapy alone in the B-14 and TAILORx trials or also chemotherapy in the TAILORx. RSClin integrates RS with tumor grade, tumor size, and age. In the study, RSClin provided more prognostic information (likelihood ratio χ2) for DR than RS or clinical-pathologic factors alone (both P <0.001, likelihood ratio test). In external validation, the RSClin risk estimate was prognostic for DR risk in the Clalit registry (P <0.001), with the estimated risk significantly correlated with risk of DR (hazard ratio, 1.73; 95% CI, 1.40-2.15; P <0.001). The study authors noted that with RSClin use in a 55-year-old woman with a 1.5-cm intermediate-grade tumor, the absolute chemotherapy benefit estimate ranges from 0% to 15% as the RS ranges from 11 to 50.
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