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Observational Study
. 2022 Jan;191(2):477-480.
doi: 10.1007/s10549-021-06464-5. Epub 2021 Nov 24.

Is the oncotype DX test useful in elderly breast cancer patients: a subgroup analysis of real-life Italian PONDx study

Sandro Barni  1 , Francesco Cognetti  2 , Fausto Petrelli  3
Affiliations
Observational Study

Is the oncotype DX test useful in elderly breast cancer patients: a subgroup analysis of real-life Italian PONDx study

Sandro Barni et al. Breast Cancer Res Treat. 2022 Jan.

Abstract

Introduction: The 21-gene Oncotype DX Breast Recurrence Score® test, (Genomic Health, Redwood City CA) has not been formally evaluated in an older cohort with estrogen receptor (ER)-positive breast cancer (BC) in term of physicians' treatment decisions. We determine the utility of Recurrence Score® (RS) result on adjuvant therapy prescription in elderly patients with resected early BC.

Material and methods: PONDx was a multicenter, prospective, observational study, and which investigated the real-life use of the Oncotype DX® test by physicians treating early BC patients in clinical practice.

Results: Data from the elderly extracted from 1724 BC patients who underwent Oncotype DX testing were available from 27 reference centers located in 6 regions of Italy (Lombardia, Lazio, Emilia Romagna, Campania, Abruzzo, and Marche). A total of 230 patients (13% of the total population) aged > 70 years were analyzed. The study primarily evaluated the impact of the Oncotype DX test on adjuvant treatment decisions. Physicians chosen chemotherapy plus endocrine therapy in 36% of elderly patients and 46% of those 50-70 years before the Oncotype DX test. After knowing the RS data, these rates fell to 23 and 33% (38 and 28% relative reduction, respectively).

Conclusions: 21-gene test may be helpful even in a relatively low-risk group as elderly patients and may avoid the toxicity of adjuvant chemotherapy in a significant amount. If the Oncotype DX test is currently adopted on a large scale among the elderly and may impact the general prognosis of elderly BC patients, it is challenging and still unproven.

Keywords: Adjuvant chemotherapy; Breast cancer; Older patients; Oncotype DX; Real life.

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