Cost analysis of using Magee scores as a surrogate of Oncotype DX for adjuvant treatment decisions in women with early breast cancer

2019 ◽  
Vol 26 (3) ◽  
pp. 889-892 ◽  
Author(s):  
Mariana A.G. Lima ◽  
Mark Clemons ◽  
Sasha Van Katwyk ◽  
Carol Stober ◽  
Susan J. Robertson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Analysis ◽  
Early Breast Cancer ◽  
Adjuvant Treatment ◽  
Treatment Decisions ◽  
Oncotype Dx

Omitting chemotherapy in more patients with early breast cancer in the post-TAILORx era.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12534-e12534
Author(s):  
Christos Markopoulos ◽  
Zoi Andromahi Sariyanni ◽  
Dimitrios C. Ziogas ◽  
Zoh Antonopoulou ◽  
Nikolaos Tsoulos
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Regression Models ◽  
Recurrence Score ◽  
Treatment Decisions ◽  
Oncotype Dx ◽  
Logistic Regression Models ◽  
Previously Treated ◽  
High Clinical Risk

e12534 Background: The purpose of this analysis is to evaluate how many patients previously treated according to OncotypeDX Recurrence Score (RS) could have been spared of Chemotherapy if the TAILORx RS data had been taken into account in the clinical treatment decisions. Methods: A series of 182 patients, 34-74 years of age with early breast cancer, treated in our Breast Unit during the last 10 years, for whom treatment decisions were based on OncotypeDX RS. The Recurrence Scores of all these patients were obtained and the actual treatment decisions that were made based on the pre-TAILORx cut-offs of RS 18 and 31 were recorded. These decisions were then re-evaluated based on the after TAILORx cut-off scores, by taking also into consideration the patients’ age. Descriptive statistics were used as well as logistic regression models to estimate the potential change in treatment decisions based on the new Oncotype Dx cut-offs. Results: In the cohort of patients we analyzed that underwent Oncotype Dx testing, 34.1% (62/182) received Chemotherapy, based on the initial pre-TAILORX cut-offs of the RS. When utilizing the new cut-offs (after TAILORx results) in combination with age, we have estimated that, for the patients > 50 years of age, a 12.7% was potentially over-treated and for those ≤50 years old, 9.1% was potentially over-treated since they have received chemotherapy with a RS below 16; additionally, 30.8% of the patients of that age that have RS between 16 and 20 have received chemotherapy even though the average chemotherapy benefit for this group is 1.6% and can go up to 6.7% if they have a high clinical risk as it was defined by the investigators of the TAILORx trial. Finally, 84,6% of patients ≤50 years old with RS between 21-25 received chemotherapy with a 6.5% potential benefit demonstrated in the TAILORx trial. Conclusions: Our analysis suggests that, by using the cut-offs of TAILORx trial, adjuvant chemotherapy could had been omitted in at least a further 11.5% of patients with early breast cancer, reassuring their quality of life without declining their prognosis.

scholarly journals The effect of Oncotype DX® on adjuvant chemotherapy treatment decisions in early breast cancer

2019 ◽  
Vol 101 (8) ◽  
pp. 596-601
Author(s):  
MA Rabie ◽  
A Rankin ◽  
A Burger ◽  
MMG Youssef
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Treatment ◽  
Recurrence Score ◽  
Treatment Decisions ◽  
Oncotype Dx ◽  
Queen Elizabeth Hospital ◽  
Intermediate Risk ◽  
Gene Assay ◽  
Risk Patients

Introduction The aim of this study was to objectively establish the value of the Oncotype DX® (ODX) gene assay in adjuvant treatment decisions for intermediate risk patients with early, oestrogen receptor positive, human epidermal growth factor receptor 2 negative, lymph node negative breast cancer at a district general hospital. Methods All patients who underwent surgery for breast cancer between January 2015 and December 2017 at Queen Elizabeth Hospital in King’s Lynn were considered for inclusion in the study. Those who did not meet the criteria for ODX referral were excluded. Patients were divided into two cohorts based on whether they were treated before or after the introduction of ODX testing in this hospital (June 2016): the pre-ODX and post-ODX groups. The primary outcome was the percentage of patients for whom adjuvant chemotherapy (AC) was recommended in each group. Results Of the 462 patients who underwent surgery during the study period, 43 met the eligibility criteria for ODX testing: 18 in the pre-ODX group and 25 in the post-ODX group. AC was recommended and given to 11 (61%) of the patients in the pre-ODX group. In the post-ODX group, AC was recommended for seven patients with an ODX Recurrence Score® (RS) of >25; this was given to six patients (24%). One patient (with a RS of 26) declined AC. ODX testing led to a significant reduction in the proportion of patients who received AC (p=0.015). Conclusions In intermediate risk patients with breast cancer, the results of the ODX gene assay may change the decision for adjuvant treatment. It represents a valuable tool to assist patients’ and clinicians’ decision making regarding adjuvant chemotherapy.

scholarly journals Impact of Commercialized Genomic Tests on Adjuvant Treatment Decisions in Early Stage Breast Cancer Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hazem I. Assi ◽  
Ibrahim A. Alameh ◽  
Jessica Khoury ◽  
Nour Abdul Halim ◽  
Fadi El Karak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Financial Burden ◽  
Treatment Decisions ◽  
Oncotype Dx ◽  
Breast Cancer Patients ◽  
Genomic Test ◽  
The Impact

Introduction. Advances in genomic techniques have been valuable in guiding decisions regarding the treatment of early breast cancer (EBC) patients. These multigene assays include Oncotype DX, Prosigna, and Endopredict. There has generally been a tendency to overtreat or undertreat patients, and having reliable prognostic factors could significantly improve rates of appropriate treatment administration. In this study, we showcase the impact of genomic tests on adjuvant treatment decisions in EBC patients. Materials and Methods. This is a retrospective study that includes EBC patients treated between December 2016 and February 2018. The physician’s choice of treatment was recorded before and after obtaining the results of the genomics tests. Baseline demographics and pathological data were collected from medical records. Results. A total of 75 patients were included. Fifty patients underwent Oncotype DX genomic analysis, 11 patients underwent Prosigna analysis, and 14 patients underwent Endopredict analysis. A total of 21 physicians’ plans (28%) were initially undecided and then carried out after obtaining genomic test results. 13 patients were planned to undergo endocrine therapy alone, while 8 were planned to undergo both endocrine therapy and chemotherapy. Treatment was changed in 26 patients (34.67%). The decision to deescalate therapy was taken in 19 patients (25.33%). The decision to escalate treatment was made in 7 patients (9.33%). Conclusion. Our study demonstrates the importance of genomics testing, as it assisted physicians in avoiding unnecessary adjuvant chemotherapy in 25.33% of patients, thus reducing side effects of chemotherapy and the financial burden on patients.

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