Tailoring adjuvant endocrine therapy for XXXX : a @entity5320 multiple-genotype-based modeling analysis and validation.

@entity1 @entity440 @entity0 @entity5320 @entity29906
PURPOSE: Previous studies have suggested that postmenopausal @entity1 with @entity0 who present with wild-type @entity5320 may actually have similar or superior recurrence-free survival outcomes when given @entity440 in place of aromatase inhibitors (AIs). The present study established a @entity5320 multiple-genotype-based model to determine the optimal endocrine therapy for @entity1 harboring wild-type @entity5320 . METHODS: We created a Markov model to determine whether @entity440 or AIs maximized 5-year disease-free survival (DFS) for extensive metabolizer (EM) @entity1 using annual hazard ratio (HR) data from the @entity29906 -98 trial. We then replicated the model by evaluating 9-year event-free survival (EFS) using HR data from the ATAC trial. In addition, we employed two-way sensitivity analyses to explore the impact of HR of decreased-metabolizer (DM) and its frequency on survival by studying a range of estimates. RESULTS: The 5-year DFS of @entity440 -treated EM @entity1 was 83.3%, which is similar to that of genotypically unselected @entity1 who received an AI (83.7%). In the validation study, we further demonstrated that the 9-year EFS of @entity440 -treated EM @entity1 was 81.4%, which is higher than that of genotypically unselected @entity1 receiving @entity440 (78.4%) and similar to that of @entity1 receiving an AI (83.2%). Two-way sensitivity analyses demonstrated the robustness of the results. CONCLUSIONS: Our modeling analyses indicate that, among EM @entity1 , the DFS/EFS outcome of @entity1 receiving @entity440 is similar to that of @entity1 receiving an AI. Further prospective clinical trials are needed to evaluate the value of the @entity5320 genotype in the selection of endocrine therapy.
