Simulation model-based clinical decision tool to identify patients where 21-gene RS testing may change decisions

There is a need for industry-independent decision tools that integrate clinicopathologic features, comorbidities, and genomic information for women with node-negative, invasive, hormone-receptor positive, human epidermal growth factor receptor-2-negative early stage breast cancer. A multi-institutional group of researchers in the USA developed a simulation model-based clinical decision tool (‘BTxChoice’) to identify patients where 21-gene recurrence score testing may change decisions. The model provides 10-year risk of distant recurrence and life-years gained with chemoendocrine versus endocrine therapy considering a woman’s age, tumor size, tumor grade, and comorbidities; with and without 21-gene recurrence score test results. The model closely reproduced observed rates in two independent data sets.