Objective:

To determine if anti-Müllerian hormone (AMH) levels can identify premenopausal women with hormone receptor–positive, HER2-negative breast cancer who may not benefit from adjuvant chemotherapy.

Approach:

• Study Design: Analysis of the phase 3 RxPONDER trial, focusing on premenopausal women with breast cancer.
• Biomarker Testing: Pretreatment serum samples from 1556 women younger than 55 years were tested for AMH, inhibin B, and other reproductive hormones.

Key Findings:

• AMH was the strongest predictor of chemotherapy benefit.
• Women with AMH concentrations below 10 pg/mL did not benefit from chemotherapy.
• Approximately 21% of premenopausal participants had AMH below the 10-pg/mL threshold.
• Ovarian reserve was more informative for predicting chemotherapy benefit than age or menopausal status.

Limitations:

• The clinically informative AMH threshold was below the reliable measurement range of several existing commercial assays.
• Further validation in additional clinical trials is required before routine clinical use.

Sources:

• Annals of Oncology