Facharzt FMH Medizinische Onkologie Practice Questions - Facharzt FMH Für Medizinische Onkologie Spécialiste FMH En Oncologie Médicale Exam

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A 56-year-old postmenopausal woman undergoes breast-conserving surgery and sentinel lymph node biopsy for an invasive ductal carcinoma of the breast. Pathology reveals a 2.2 cm, grade 2 tumor with 2 positive sentinel lymph nodes (pT2 pN1a M0). The tumor is estrogen receptor (ER) 95% positive, progesterone receptor (PR) 80% positive, and HER2-negative (IHC 1+). A 21-gene recurrence score (Oncotype DX) assay returns a recurrence score of 28. According to ESMO guidelines and landmark clinical trial data, what is the most appropriate systemic adjuvant treatment strategy?

Adjuvant chemotherapy (anthracycline/taxane-based) followed by an aromatase inhibitor plus 2 years of the CDK4/6 inhibitor abemaciclib Aromatase inhibitor monotherapy for 5 years without chemotherapy, as postmenopausal node-positive luminal disease does not benefit from cytotoxic therapy Adjuvant trastuzumab emtansine (T-DM1) for 14 cycles followed by tamoxifen monotherapy for 10 years Ovarian function suppression with goserelin plus tamoxifen without chemotherapy or CDK4/6 inhibition

Correct Answer:

Adjuvant chemotherapy (anthracycline/taxane-based) followed by an aromatase inhibitor plus 2 years of the CDK4/6 inhibitor abemaciclib

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