Biomarker-based risk stratification for predicting late recurrence and benefit of extended endocrine therapy: A secondary analysis of the IDEAL trial.
BreastAug 18, 2026 (epub)
Tejal D Durgekar, Shyamili Goutham, Xi Zhang et al.
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In 30 seconds
This secondary analysis of the Phase III IDEAL trial evaluated the CanAssist Breast (CAB) biomarker for predicting late recurrences in 3052 hormone receptor-positive, HER2-negative early breast cancer patients. The study found that the ultra-high-risk subgroup identified by CAB showed a 10% improvement in distant recurrence-free survival (DRFS) with 5 years of extended endocrine therapy compared to 2.5 years.
Key findings
- CAB stratified patients into low-risk, high-risk, and ultra-high-risk categories with proportions of 69:20:11 in the pooled cohort.
- The ultra-high-risk group showed a 10% improvement in DRFS with 5 years of extended endocrine therapy compared to 2.5 years.
- In the CAB-low-risk group, the improvement in DRFS was only 1%, and 1.5% in the high-risk group.
Why it matters
Identifying patients at elevated risk of late recurrence can guide treatment decisions regarding extended endocrine therapy, potentially improving long-term outcomes in hormone receptor-positive breast cancer.