ArticleJCO precision oncology2026
Prediction of Anthracycline Benefit in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Early-Stage Breast Cancer by the MammaPrint 70-Gene Signature for Patients Enrolled in the FLEX Study.
Article in JCO precision 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.
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Abstract
purposeRandomized trials have not demonstrated clear benefit from anthracyclines for patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (EBC). The MammaPrint 70-gene signature, specifically the High-Risk 1 (H1) and High-Risk 2 (H2) subgroups, was evaluated in predicting benefit from anthracycline- and taxane-based chemotherapy (AC-T) compared with taxane/cyclophosphamide (TC) in hormone receptor-positive HER2- EBC. MATERIALS AND
methodsThis analysis used prospectively collected real-world data from patients enrolled in the FLEX study with stage I-III hormone receptor-positive HER2- EBC, MammaPrint High-Risk, and BluePrint Luminal B tumors who received adjuvant AC-T or TC. Inverse probability of treatment weighting (IPTW) was performed to balance clinical characteristics between treatment groups. The association between the chemotherapy regimen and 3-year invasive disease-free survival (IDFS) was assessed using Kaplan-Meier estimates and Cox proportional hazards models.
resultsAmong patients with H1 cancers (n = 1,106), 3-year IDFS did not differ between AC-T and TC (95.9%
conclusionPatients with MammaPrint H2 tumors had a clinically meaningful benefit from anthracycline-containing chemotherapy, whereas patients with H1 tumors did not derive more benefit from AC-T than from TC despite overlapping high-risk features. These findings support the use of MammaPrint to inform chemotherapy regimen selection and warrant further validation.
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