Oncotype DX® Influences Treatment Decisions in Node-positive Breast Cancer

Posted on December 14th, 2009 by

Use of the Oncotype DX® test to estimate recurrence risk and chemotherapy benefit influences treatment decisions for women with node-positive breast cancer. These results were presented at the San Antonio Breast Cancer Symposium (SABCS).

Oncotype DX is a genomic test that previously has been shown to predict the likelihood of cancer recurrence in women with early-stage, estrogen receptor-positive breast cancer that is treated with hormonal therapy. Women with a low risk of recurrence may derive little benefit from chemotherapy. Oncotype DX evaluates the activity of 21 genes from a sample of the patient’s cancer to determine the patient’s Recurrence Score. The Recurrence Score ranges from 0 to 100, with a higher score indicating a greater risk of recurrence. Oncotype DX has been added to U.S. medical guidelines for early-stage breast cancer.

Oncotype DX was initially validated among women with node-negative breast cancer, but the test also appears to provide important information about women with node-positive breast cancer. In another study presented at SABCS and published in Lancet Oncology, women with node-positive breast cancer but a low Recurrence Score did not appear to benefit from the addition of chemotherapy to hormonal therapy with tamoxifen [Nolvadex®].[1]

The current study involved a survey of 160 medical oncologists about their experience with Oncotype DX in patients with hormone receptor-positive, node-positive breast cancer.[2] The results indicated that treatment recommendations for women with 1-3 positive nodes frequently changed based on the Recurrence Score.

  • In the 138 cases where the physician had a specific treatment recommendation prior to getting the Recurrence Score, recommended treatment changed from hormonal therapy plus chemotherapy to hormonal therapy alone in 46 patients (33%). Treatment changed from hormonal therapy alone to hormonal therapy plus chemotherapy in 13 patients (9%). Other changes, such as changes in treatment intensity, were reported in 11 patients (8%).

These results indicate that information about the Oncotype DX Recurrence Score can influence treatment decisions among women with node-positive breast cancer.


[1] Albain KS, Barlow WE, Shak S et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised clinical trial. Lancet Oncology. Early online publication December 10, 2009.

[2] Oratz R, Chao C, Skrzypczak S et al. Effect of 21-Gene Recurrence Score Results on Treatment Recommendations in Patients with Lymph Node-Positive, Estrogen Receptor-Positive Breast Cancer. Presented at the 32nd CTRC-AACR San Antonio Breast Cancer Symposium. December 9-13, 2009. San Antonio, TX. Abstract 2031.

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