{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T04:43:03Z","timestamp":1793508183952,"version":"4.5.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"am","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The NATALEE and monarchE trials showed statistically significant invasive disease-free survival benefits with the addition of a cyclin-dependent kinases 4 and 6 (CDK4, CDK6) inhibitor to endocrine therapy in patients with hormone receptor\u2013positive, ERBB2 (HER2)-negative early breast cancer. This study evaluated outcomes in real-world patients before widespread availability of adjuvant CDK4 and CDK6 inhibitors, depending on nodal status, including N0 disease with and without high-risk features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Anonymized data from the Flatiron Health US electronic health record database (2011-2023) were analyzed. Adults with American Joint Committee on Cancer anatomic stage I to III hormone receptor\u2013positive\/HER2-negative early breast cancer who had undergone surgery and adjuvant endocrine therapy were included. Overall and distant recurrence and all-cause mortality risks were assessed descriptively across nodal subgroups using Cox proportional hazards models. Recurrence-free survival, distant-recurrence free survival, and overall survival were evaluated using Kaplan-Meier methods in the NATALEE-eligible and monarchE-eligible populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 7481 analyzed patients, 5387 (72.0%) had N0 disease, including 604 (11.2%) with high-risk features and 4783 (88.8%) without. In addition, 1626 (21.7%) had N1 and 468 (6.3%) had N2 to N3 disease. At a potential median follow-up of 78.0\u2009months, the N0 high-risk subgroup showed overall and distant recurrence and mortality risks similar to those in the N1 subgroup. Overall, 2534 patients (33.9%) were NATALEE eligible, and 1157 (15.5%) were monarchE eligible. Both populations showed relatively high 5-year distant recurrence rates (distant recurrence-free survival\u2009=\u200983.1% and 74.6%, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This contemporary real-world analysis highlights a meaningful recurrence risk in the broader hormone receptor\u2013positive\/HER2-negative early breast cancer population, irrespective of nodal status, and emphasizes the need for effective treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag201","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:51:49Z","timestamp":1783511509000},"source":"Crossref","is-referenced-by-count":2,"title":["Recurrence risk in HR-positive\/HER2-negative early breast cancer: real-world US electronic health record 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