Posted on July 13th, 2012 by
Oncotype DX Recurrence Score results significantly impact treatment recommendations in estrogen receptor-positive early-stage breast cancer with no lymph node involvement, according to the results of a study presented at the 2012 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Illinois—which showed that after receiving the score, physicians changed their chemotherapy recommendation in 30 percent of cases.
Gene expression profiling explores the patterns of genes that are active in tumor cells. Studies suggest that gene expression may provide important information about prognosis or likely response to treatment in several types of cancer. For example, among women with early-stage, estrogen-receptor (ER)-positive breast cancer, the Oncotype DX breast cancer test has been shown to predict the likelihood of cancer recurrence and the likelihood of benefit from chemotherapy. As a result, the test has been added to medical guidelines for early-stage breast cancer.
Use of the Oncotype DX 21-gene Recurrence Score assay (RS) has grown significantly in the United States since its introduction; however, it is not yet routinely ordered by oncologists in most parts of Canada. Researchers in British Columbia conducted a study to examine the impact of the Oncotype DX test on physicians’ treatment recommendations in ER-positive, node-negative breast cancer.
The study included 150 patients with ER-positive, node-negative, early-stage breast cancer. Prior to undergoing the Oncotype DX test, patients and physicians were surveyed regarding their treatment preferences and level of confidence about the treatment. Patients also responded to questions regarding decisional conflict. After the Oncotype DX test, patients and physicians were surveyed again and the results indicated that the Recurrence Score (RS) results significantly impacted treatment recommendations.
After receiving the RS results, physicians changed their treatment recommendation in 30 percent of cases—in 10 percent of cases they chose to add adjuvant chemotherapy and in 20 percent of cases they chose to omit it and use only hormonal therapy. Furthermore, there was an overall significant improvement in physician confidence after the RS results and a significant decrease in patient decisional conflict.
The researchers concluded that the Oncotype DX test significantly impacts treatment decisions and can ensure that patients with early-stage breast cancer patients who will benefit from chemotherapy will receive it, while others will be spared unnecessary treatment and side effects.
Breast cancer is the leading type of cancer diagnosed among women in British Columbia. Currently, the Oncotype DX test is reimbursed publicly for qualified patients in Ontario, Quebec, and Saskatchewan, with a number of provinces considering public funding for qualified breast cancer patients.
Davidson JA, Cromwell I, Ellard S, et al. A prospective clinical utility study of the impact of the 21-gene recurrence score assay (Oncotype DX) in estrogen receptor positive (ER+) node negative (pN0) breast cancer in academic Canadian centers. Presented at the 2012 annual meeting of the American Society of Clinical Oncology, June 1-5, 2012, Chicago, IL. Abstract 549.
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