Abirami Sivapiragasam, MD, discusses how to interpret OPTIMA trial findings in premenopausal patients with ER-positive, HER2-negative early breast cancer, a group where chemotherapy decisions remain challenging.
She reviews prior data suggesting modest chemotherapy benefit in patients with 1–3 positive lymph nodes may be driven by ovarian function suppression rather than direct cytotoxic effects.
With ongoing research like the OFSET trial comparing chemotherapy plus endocrine therapy versus endocrine therapy alone in patients with low Oncotype scores, Dr. Siva emphasizes caution in changing practice.
Given the relatively short 3.9-year follow-up in OPTIMA, she highlights the need for longer-term data before broadly omitting chemotherapy, particularly in patients with higher nodal burden.
Abirami Sivapiragasam, MD, discusses how to interpret OPTIMA trial findings in premenopausal patients with ER-positive, HER2-negative early breast cancer, a group where chemotherapy decisions remain challenging. She reviews prior data suggesting modest chemotherapy benefit in patients with 1–3 positive lymph nodes may be driven by ovarian function suppression rather than direct cytotoxic effects. With ongoing research like the OFSET trial comparing chemotherapy plus endocrine therapy versus endocrine therapy alone in patients with low Oncotype scores, Dr. Siva emphasizes caution in changing practice. Given the relatively short 3.9-year follow-up in OPTIMA, she highlights the need for longer-term data before broadly omitting chemotherapy, particularly in patients with higher nodal burden.
