{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:27:39Z","timestamp":1776356859670,"version":"3.51.2"},"reference-count":51,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Oncotype DX (ODX) is a validated gene expression assay that provides prognostic and predictive information to guide adjuvant chemotherapy (ACT) decisions in hormone receptor\u2013positive, HER2-negative (HR+\/HER2\u2013) early breast cancer (eBC), including node-negative (N0) and 1-3 node-positive (N1) disease. In Brazil, limited access to gene expression signatures (GES) remains a barrier to individualized treatment decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective study across nine Brazilian private cancer centers to evaluate clinicopathologic predictors of high genomic risk (ODX recurrence score [RS] &gt;25) and to assess the clinical impact of ODX on ACT decision making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Between 2005 and 2024, 935 patients were included, with a notably higher representation of young (\u226440 years: 10.9%) and premenopausal (40.7%) women than typically reported in randomized clinical trials. Ki-67 &gt;20%, progesterone receptor (PR) expression \u226430%, and histologic grade 3 were independently associated with high RS in both univariable and multivariable analyses (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;.001), with Ki-67 emerging as the strongest clinicopathologic predictor. Overall, ODX testing was associated with an estimated 12.6% absolute reduction in ACT recommendations, with substantial impact among postmenopausal patients with N1 disease (94% absolute reduction) and N0 patients older than 50 years with high clinical risk (65.2% absolute reduction). With a median follow-up of 4.8 years, the estimated 5-year real-world invasive disease-free survival and distant disease-free survival were 100% and 100% for those with RS &lt;11, 98.2% and 99.4% for RS 11-25, and 90.9% and 92.5% for RS &gt;25, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In this data set, ODX demonstrated utility in guiding ACT decision making and supporting personalized treatment by reducing both overtreatment and undertreatment. In resource-constrained settings, surrogate markers such as Ki-67, PR expression, and histologic grade may serve as practical tools to guide risk-adapted clinical decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-25-00899","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:59:06Z","timestamp":1772830746000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Impact and Clinicopathologic Correlations of Oncotype DX in Hormone Receptor\u2013Positive\/HER2\u2013Negative Early Breast Cancer: Real-World Evidence From a Large Brazilian Cohort (GBECAM 0520)"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6344-3544","authenticated-orcid":true,"given":"Leandro Jonata de Carvalho","family":"Oliveira","sequence":"first","affiliation":[{"name":"Grupo Brasileiro de Estudos em C\u00e2ncer de Mama (GBECAM), S\u00e3o Paulo, 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