ArticleCancer2024
Validation of the RSClin risk calculator in the National Cancer Data Base.
Article in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Clinical and Genomic Risk for Late Breast Cancer Recurrence and Survival.NEJM evidence · 2024Pooled it
- Development and Validation of a Multimodal Clinical, Pathologic, and Genomic Model for Breast Cancer Recurrence.medRxiv : the preprint server for health sciences · 2026Article
- Article
- Machine Learning-Based Prediction of Distant Recurrence Risk and Ribociclib Treatment Effect in HR+/HER2- Early Breast Cancer Using Real-World and NATALEE Data.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Impact of anthracyclines in genomic high-risk, node-negative, HR-positive/HER2-negative breast cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2025Article
- Mortality Prediction Modeling for Patients with Breast Cancer Based on Explainable Machine Learning.Cancers · 2024Article
- Differences in 21-Gene and PAM50 Recurrence Scores in Younger and Black Women With Breast Cancer.JCO precision oncology · 2024Article
- Development and validation of a clinical breast cancer tool for accurate prediction of recurrence.NPJ breast cancer · 2024Article
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGuidelines recommend the use of genomic assays such as OncotypeDx to aid in decisions regarding the use of chemotherapy for hormone receptor-positive, HER2-negative (HR+/HER2-) breast cancer. The RSClin prognostic tool integrates OncotypeDx and clinicopathologic features to predict distant recurrence and chemotherapy benefit, but further validation is needed before broad clinical adoption.
methodsThis study included patients from the National Cancer Data Base (NCDB) who were diagnosed with stage I-III HR+/HER2- breast cancer from 2010 to 2020 and received adjuvant endocrine therapy with or without chemotherapy. RSClin-predicted chemotherapy benefit was stratified into low (<3% reduction in distant recurrence), intermediate (3%-5%), and high (>5%). Cox models were used to model mortality adjusted for age, comorbidity index, insurance, and race/ethnicity.
resultsA total of 285,441 patients were identified for inclusion from the NCDB, with an average age of 60 years and a median follow-up of 58 months. Chemotherapy was associated with improved overall survival only for those predicted to have intermediate (adjusted hazard ratio [aHR], 0.68; 95% confidence interval [CI], 0.60-0.79) and high benefit per RSClin (aHR, 0.66; 95% CI, 0.61-0.72). Consistent benefit was seen in the subset with a low OncotypeDx score (<26) and intermediate (aHR, 0.66; 95% CI, 0.53-0.82) or high (aHR, 0.71; 95% CI, 0.58-0.86) RSClin-predicted benefit. No survival benefit with chemotherapy was seen in patients with a high OncotypeDx score (≥26) and low benefit per RSClin (aHR, 1.70; 95% CI, 0.41-6.99).
conclusionsRSClin may identify high-risk patients who benefit from treatment intensification more accurately than OncotypeDx, and further prospective study is needed.
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