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Title: The IHC4+C score: an affordable and reproducible non-molecular decision-aid in hormone receptor-positive breast cancer. Does it still hold value for patients in 2020?
Austin Authors: Harel, Nadav;Cheema, Steven ;Williams, David S ;Ireland-Jenkin, Kerryn ;Fancourt, Tineke ;Dodson, Andrew;Yeo, Belinda 
Affiliation: Department of Clinical Pathology, University of Melbourne, Melbourne, Australia
Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, UK
Medicine (University of Melbourne)
Medical Oncology
School of Cancer Medicine, La Trobe University
Anatomical Pathology
Olivia Newton-John Cancer Research Institute
Issue Date: Aug-2021
Date: 2021-02-10
Publication information: Asia-Pacific Journal of Clinical Oncology 2021; 17(4): 368-376
Abstract: The majority of women diagnosed with early breast cancer have hormone-receptor positive (HR+)/HER2-negative disease. Adjuvant endocrine therapy provides substantial risk reduction benefits in virtually all patients. The role of adjuvant chemotherapy in certain subsets of patients is equivocal. This paper sought to evaluate the role of the IHC4+C score to aid this clinical decision in addition to providing an overview of the current molecular and non- molecular tools available in the adjuvant setting. This prospective study included 53 post-operative HR+/HER2- negative early breast cancer patients selected from the multidiscipliniary team meeting between August 2017 and January 2020. IHC4+C testing was requested by clinicians for patients in whom the availability of the score may have impacted adjuvant decision-making. Adjuvant treatment decisions were recorded at three time points (prior and post IHC4+C scoring as well as the patient's final decision). The primary goal was the proportion of patients who were spared chemotherapy following the availability of IHC4+C scores to impact on clinicians' recommendations for adjuvant systemic therapy. A total of 34 patients (64%) were initially recommended to undergo chemotherapy or to consider chemotherapy. With the availability of the IHC4+C score, only 17 patients (32%) underwent chemotherapy, demonstrating a substantial reduction in the frequency of chemotherapy prescribing. Conclusion This study demonstrates that when utilized appropriately in a multidisciplinary setting, the IHC4+C algorithm is an alternative, reproducible and affordable tool with a proven capacity to stratify risk and to spare a large proportion of patients from undergoing chemotherapy.
DOI: 10.1111/ajco.13507
ORCID: 0000-0003-2061-1397
Journal: Asia-Pacific Journal of Clinical Oncology
PubMed URL: 33567144
Type: Journal Article
Subjects: HER-2 negative breast cancer
adjuvant treatment
medical oncology < Group 1: Major Specialty
Appears in Collections:Journal articles

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