{"entity":{"id":"genomic-assay-to-chemo-omission","kind":"pairing","name":"Gene-expression assay → chemotherapy omission","aka":[],"tldr":"A gene test on the tumour decides who can skip chemotherapy without losing protection.","summary":"This diagnostic-therapeutic pairing uses a gene-expression assay on the tumour, chiefly Oncotype DX and also MammaPrint, to decide which women with HR-positive, HER2-negative breast cancer can safely omit adjuvant cytotoxic chemotherapy. Proliferation- and oestrogen-receptor-related gene expression predicts both chemosensitivity and prognosis better than clinical and pathological factors alone. TAILORx in node-negative disease and RxPONDER in postmenopausal women with one to three involved nodes found no chemotherapy benefit at a recurrence score of 25 or below, and MINDACT with MammaPrint concurs; together these are three large prospective trials. Premenopausal women with intermediate scores still gain from chemotherapy, possibly through ovarian suppression.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT00310180: TAILORx","url":"https://clinicaltrials.gov/study/NCT00310180"},{"label":"ClinicalTrials.gov NCT01272037: RxPONDER (SWOG S1007)","url":"https://clinicaltrials.gov/study/NCT01272037"}],"tags":[],"related":[],"cancers":["breast-hr-positive"],"sections":[],"technologies":[],"targets":[],"drugs":["oncotype-dx","mammaprint"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["tailorx","rxponder"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"oncotype-dx","b":"cytotoxic-chemotherapy","rationale":"Proliferation and ER-related gene expression predicts chemosensitivity and prognosis better than clinicopathologic factors alone.","evidence":"Three large prospective trials (>20,000 women).","pairingType":"diagnostic-therapeutic"},"route":"/pairings/genomic-assay-to-chemo-omission/","neighbours":{"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"}],"drug":[{"id":"mammaprint","kind":"drug","name":"MammaPrint (70-gene signature)","route":"/drugs/mammaprint/"},{"id":"oncotype-dx","kind":"drug","name":"Oncotype DX","route":"/drugs/oncotype-dx/"}],"trial":[{"id":"rxponder","kind":"trial","name":"RxPONDER (SWOG S1007)","route":"/trials/rxponder/"},{"id":"tailorx","kind":"trial","name":"TAILORx","route":"/trials/tailorx/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}]}}