Evidence map›Paper›PMID 42214047›Full record

ArticleJCO global oncology2026

Accessible Clinical Tool for Prognosis and Chemotherapy Prediction in Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer in Diverse and Low-Resource Settings.

Rubem Jose Peres Moreira, Jose Bines, Asim Dhungana, Jincong Q Freeman, Poornima Saha, Megan E Sullivan, Katharine Yao, Elbio M Flores, Dezheng Huo, Alexander T Pearson and 3 more

Abstract read
In one paragraph

Article in JCO global oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Rubem Jose Peres MoreiraMedical Oncology, Instituto Nacional de Cancer, Rio de Janeiro, Brazil.ORCID 0009-0003-7607-3142
Jose BinesMedical Oncology, Instituto Nacional de Cancer, Rio de Janeiro, Brazil.ORCID 0000-0003-2465-8854
Asim DhunganaPritzker School of Medicine, University of Chicago, Chicago, IL.
Jincong Q FreemanDepartment of Public Health Sciences, University of Chicago, Chicago, IL.ORCID 0000-0002-1119-2146
Poornima SahaDepartment of Medicine, NorthShore University HealthSystem, Evanston, IL.ORCID 0009-0005-6609-7188
Megan E SullivanDepartment of Pathology, NorthShore University HealthSystem, Evanston, IL.ORCID 0009-0005-0687-6841
Katharine YaoDepartment of Surgery, NorthShore University HealthSystem, Evanston, IL.
Elbio M FloresDepartment of Pathology, Ingalls Memorial Hospital, Harvey, IL.
Dezheng HuoDepartment of Public Health Sciences, University of Chicago, Chicago, IL.ORCID 0000-0002-4041-1678
Alexander T PearsonDepartment of Medicine, University of Chicago, Chicago, IL.ORCID 0000-0003-2801-7456
Isabele Avila SmallData Management and Analysis, Instituto Nacional de Cancer, Rio de Janeiro, Brazil.ORCID 0000-0003-0598-9295
Olufunmilayo I OlopadeDepartment of Medicine, University of Chicago, Chicago, IL.ORCID 0000-0002-9936-1599
Frederick Matthew HowardDepartment of Medicine, University of Chicago, Chicago, IL.ORCID 0000-0002-6039-1141

Funding

SPECIALIZED TRAINING PROGRAM IN THE DEMOGRAPHY &ECON.T32AG000243 · NIA · UNIVERSITY OF CHICAGO · PI DAVID O MELTZER · 1994 to 2026
$8.2M
UChicago Interdisciplinary Cancer Health Disparities SPOREP20CA233307 · NCI · UNIVERSITY OF CHICAGO · PI KARCZMAR, GREGORY S. · 2018 to 2020
$3.4M
Integrating Clinical, Pathologic, and Immune Features to Predict Breast Cancer Recurrence and Chemotherapy BenefitK08CA283261 · NCI · UNIVERSITY OF CHICAGO · PI Frederick Matthew Howard · 2023 to 2026
$806k
NCI NIH HHS K08 CA283261NCI NIH HHS P20 CA233307NIA NIH HHS T32 AG000243
6 · The paper itself

Abstract

purposeGenomic assays are commonly used to predict breast cancer recurrence but remain inaccessible in low-resource settings, often leading to unnecessary chemotherapy. We previously optimized a LASSO-penalized regression model incorporating quantitative clinicopathologic features to predict genomic risk. Here, we present validation and clinical utility in an international cohort.

methodsWe retrospectively analyzed patients with early-stage hormone receptor-positive/human epidermal growth factor receptor 2-negative breast cancer treated in Chicago and Rio de Janeiro. Model accuracy for predicting high Oncotype DX (ODX) scores was evaluated using area under the receiver operating characteristic curve (AUROC) in Chicago cohorts. Survival outcomes-disease-free interval (DFI), disease-free survival (DFS), and overall survival (OS)-were compared by Kaplan-Meier and Cox regression using a predefined threshold for high-risk disease. Adjusted models examined chemotherapy benefit by predicted risk. Estimated cost was compared between testing strategies and chemotherapy allocation in Brazil and the United States. The study was approved by the Brazilian Research Ethics Committee on October 24, 2024, under CAAE number 67993323.6.0000.5274. Due to the retrospective nature of the study, which involved only data collection from electronic medical records, the requirement for informed consent was waived by the Ethics Committee. Additionally, the study is covered under Institutional Review Board 22-0707 at the University of Chicago.

resultsWe included 1,566 patients from Chicago and 296 from Rio de Janeiro. The estrogen receptor/progesterone receptor/Ki-67 model showed strong performance for ODX prediction (AUROC 0.81 and 0.91).Compared with high-risk patients, low-risk patients had superior 5-year DFI (98.0%

conclusionOur model accurately predicted recurrence and outcomes across US and Brazilian cohorts, supporting treatment de-escalation in low-risk patients and promoting equitable care where genomic testing is limited.

Indexed as

Breast NeoplasmsErb-b2 Receptor Tyrosine KinasesAdultAgedBrazilFemaleHumansMiddle AgedPrognosisReceptors, EstrogenReceptors, ProgesteroneRetrospective StudiesERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, Progesterone

Identifiers

PMID42214047
PMCPMC13268115

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.