Thank you for giving me the opportunity to talk about my presentation at San Antonio. I presented updated follow up data of the MINDACT trial. And the MINDACT trial ran from 2007 to 2011. It included patients in nine European countries, including the UK, to understand which patients based on a clinical risk assessment of their first diagnosis of breast cancer. So it's about early diagnosed patients.
The clinical and pathological diagnostic assessments integrated with genomic signature of their breast tumor tissue and that was the 70-gene prognosis-signature MammaPrint. How can we combine those two and understand of patients who are then low risk and low risk by the one or low risk by one of those and high risk by the others? How should they be treated? In particularly we are interested in, do they all need chemotherapy or is there a group where we can safely forgo chemotherapy?
So on the updated results, we show that women that are post-menopausal. If they are clinically high risk and low risk that their survival is almost exactly the same with or without chemotherapy. They have an eight year survival without recurrence of their disease. That is, first of all, really good about 95%. But secondly, it's only 0.2% survival difference.
So there's really no benefit of chemotherapy.
So the trial also studied, of course, patients who are clinically low risk. And my presentation at San Antonio was to highlight the results of those that are low risk. And what do we identify in those? And how can they be better managed?
What we showed was that 81% of the patients were both clinical and MammaPrint low risk, then their survival is extremely good. It's almost nine years. Their survival is also about 95%. And those that are clinically low but their tumor biology says high risk, there's about a 3% survival difference. So they're almost nine year survival is 91%.
So the question then is, how do they benefit from chemotherapy? So this was a very small group so we didn't have that much power. We couldn't show any benefit from chemotherapy. But it remains that if the tumor biology says high risk that the whole group has a survival of 91%. So we need more data to further understand if we really the chemotherapy gives a survival benefit.
But suffice it to say that clinically low risk patients to begin with as a group already have a very good survival. But if the tumor says high risk, decreased survival does sort of indicate that some adjuvant treatment might be beneficial.
Maybe first of all again, let's look at the age difference. Another way to look at tumor biology and prognosis prediction, besides MammaPrint which we have been studying in MINDACT, of course there is the test called Oncotype that has been mainly used in hormone receptor positive patients. But for comparison in MINDACT, we also look just at the hormone-receptor positive for HER2-negative patients.
So for both trials, TAILORx and MINDACT and now also RxPONDER for women diagnosed as of age 50 that are clinically high risk and genomic low risk, there is no survival benefit from adding chemotherapy. So that's very clear and very good news for women diagnosed when they're post-menopausal over age 50, which is the majority of all breast cancer diagnosis, that clinical tests such as MammaPrint and oncotype can help to decide if chemotherapy is needed. Because of course if you're a clinical high risk and genomic test high risk, so to speak high-high, then chemotherapy does give the benefit for survival.
But if you're clinically genomic low, then both trials or those three trials they'll show that there's no benefit of chemotherapy. So my index included both lymph node negative and lymph node positive patients up to three positive nodes. TAILORx only included lymph node negative patients. And now RxPONDER has added that same result for patients with one, two, three, positive nodes.
So now for lymph node negative as well as one, two, three, positive node, for early breast cancer patients it's clear [INAUDIBLE] diagnosed under 50. If the genomic says low risk, that they can safely forgo chemotherapy.
So then to turn to the pre-menopausal patients diagnosed below age 50, all three trials also show the same. That for patients that are clinical high risk, and genomics low risk, and diagnosed under 50, there seems to be a benefit of chemotherapy of a few percentage points depending on which study and which test it ranges. I think MammaPrint almost 5% to oncotype between 6% and 9%. There is a benefit of chemotherapy. But this benefit seems to occur later in follow up.
And chemotherapy besides the cytotoxic effect also has a ovarian suppression effect. So the discussion has been, up until now, and neither one of those trials can prove this, if any patients in those trials were all treated with mainly only tamoxifen, there's like up to 15% or 20% who got ovarian suppression of these pre-menopausal women. If one would have added ovarian suppression as part of the treatments, either by drug treatments or by removing the ovaries, which is sometimes done, would that have led to a survival game similar to now what we see from chemotherapy?
And so other trials, not mine or TAILORx, have shown that ovarian suppression can give such a gain in survival. So now the question is, since this has not been formally proven in neither MINDACT, TAILORx, or RxPONDER, is the information from those other trials, like the soft trial, sufficient to actually recommend ovarian suppression? Or do the trials now lead to the conclusion that all these women need chemotherapy? So nobody knows the answer. It's up for discussion and being discussed.
And so I think it's a conversation between the patients and the clinicians what might be best or most preferred situation.