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. 2020 Apr;180(3):809-817.
doi: 10.1007/s10549-020-05578-6. Epub 2020 Mar 13.

The impact of Oncotype DX breast cancer assay results on clinical practice: a UK experience

Valerie E Crolley  1   2 , Husam Marashi  3 , Shabbir Rawther  4 , Bhawna Sirohi  5 , Marina Parton  6 , Janine Graham  7 , Anup Vinayan  8   9 , Stephanie Sutherland  9 , Anne Rigg  10 , Anshu Wadhawan  11 , Catherine Harper-Wynne  12 , Emma Spurrell  13 , Hannah Bond  14 , Fharat Raja  15   16 , Judy King  17
Affiliations

The impact of Oncotype DX breast cancer assay results on clinical practice: a UK experience

Valerie E Crolley et al. Breast Cancer Res Treat. 2020 Apr.

Abstract

Background: Genomic tests are increasingly being used by clinicians when considering adjuvant chemotherapy for patients with oestrogen receptor-positive (ER+), human epidermal growth factor 2-negative (HER2-) breast cancer. The Oncotype DX breast recurrence score assay was the first test available in the UK National Health Service. This study looked at how UK clinicians were interpreting Recurrence Scores (RS) in everyday practice.

Methods: RS, patient and tumour characteristics and adjuvant therapy details were retrospectively collected for 713 patients from 14 UK cancer centres. Risk by RS-pathology-clinical (RSPC) was calculated and compared to the low/intermediate/risk categories, both as originally defined (RS < 18, 18-30 and > 30) and also using redefined boundaries (RS < 11, 11-25 and > 25).

Results: 49.8%, 36.2% and 14% of patients were at low (RS < 18), intermediate (RS 18-30) and high (RS > 30) risk of recurrence, respectively. Overall 26.7% received adjuvant chemotherapy. 49.2% of those were RS > 30; 93.3% of patients were RS > 25. Concordance between RS and RSPC improved when intermediate risk was defined as RS 11-25.

Conclusions: This real-world data demonstrate the value of genomic tests in reducing the use of adjuvant chemotherapy in breast cancer. Incorporating clinical characteristics or RSPC scores gives additional prognostic information which may also aid clinicians' decision making.

Keywords: Adjuvant chemotherapy; Biomarkers; Breast cancer; Early breast cancer; Oncotype DX breast recurrence score assay.

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Conflict of interest statement

J. King, H. Marashi, M. Parton, A. Rigg, C. Harper-Wynne and F. Raja have received Advisory Board honoraria from Genomic Health. V. Crolley, B. Sirohi, S. Rawther, J. Graham, A. Vinayan, S. Sutherland, A. Wahawan, E. Spurrell and H. Bond declare no conflict of interest.

Figures

Fig. 1
Fig. 1
a Distribution of patients by recurrence score (RS); b chemotherapy use according to RS; c, d distribution of patients and chemotherapy use according to the revised TAILORx definitions of low-, intermediate- and high-risk RS
Fig. 2
Fig. 2
Oncologists’ recommendation to patients, and subsequent uptake of chemotherapy in patients with a low-risk recurrence score (RS) (< 18); b intermediate-risk RS (18–30); c high-risk RS (> 30)
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30. doi: 10.3322/caac.21387. - DOI - PubMed
    1. Cancer Research UK (2018) Breast cancer incidence (invasive) statistics. In: Cancer Res. UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/s.... Accessed 4 Jun 2018
    1. Munoz D, Near AM, Van Ravesteyn NT, et al. Effects of screening and systemic adjuvant therapy on ER-specific US breast cancer mortality. J Natl Cancer Inst. 2014 doi: 10.1093/jnci/dju289. - DOI - PMC - PubMed
    1. National Institute for Health and Care Excellence Gene expression profiling and expanded immunohistochemistry tests for guiding adjuvant chemotherapy decisions in early breast cancer management : MammaPrint, Oncotype DX, IHC4 and Mammostrat. NICE Diagn Guid. 2013;10:1–57.
    1. National Cancer Institute NCCN guidelines: breast cancer. Natl Compr Cancer Netw Version. 2017 doi: 10.1016/B978-0-323-24098-7.00064-2. - DOI

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