Decisions on adjuvant chemotherapy for patients with breast cancer based on clinical and evolving Oncotype DX criteria.

Zekri, Jamal; Al‐Foheidi, Meteb; Alata, Maaz Kamal; Rasmy, Ayman; Rasool, Haleem J.; Abdelrahman, Hossam A.; Hussain, Adnan; Sorour, Yasser; Mashhour, Miral

doi:10.1200/jco.2019.37.15_suppl.e12009

Cited by 2 publications

(4 citation statements)

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“…Although a new classification has been proposed by the TAILORx data (low: < 11, intermediate: 11-25, and high: > 25) [ 10 ]. Our study applied the traditional classification which is supported by the observation of Zekri et al that found no statistically significant difference in prescribing AC by three blinded oncologists using the two classifications [ 21 ]. Controversy and challenge in the management of patients with intermediate RS of 11 to 17 exist when applying the updated classification.…”

Section: Discussionsupporting

confidence: 60%

“…The mean ODx recurrence score of our cohort was 17.8 ± 8.6. Categorical distribution of the RS revealed 79 cases (54.5%) had low-risk (0-17), 55 (37.9%) had intermediate-risk (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and only 11 (7.6%) had high-risk (31-100). The progesterone receptor was positive in 139 cases (95.9%) and negative in only six cases (4.1%).…”

Section: Resultsmentioning

confidence: 99%

“…The descriptive statistics were given as mean ± SD or median with quartiles for numerical variables and as frequencies and percentages for categorical variables. In the analysis, the ODx risk scores were used as continuous variables as well as based on old RS grouping, categorized into low (0-17), intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and high risk (≥ 31) groups. Microsoft Excel and IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY) was used for data entry and analysis.…”

Section: Methodsmentioning

confidence: 99%

“…It provides a continuous numeric recurrence score (RS) ranging from 0 to 100 or divided into low (0-17), intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and high scores (≥ 31) [8]. The recent TAILORx data redefined these risk categories for < 50 years old patients into low risk (< 16), intermediate (16)(17)(18)(19)(20)(21)(22)(23)(24)(25), and high-risk groups (> 25) [10]. The 21 genes assay includes 16 cancer genes subdivided into five proliferative genes (Ki67, STK15, Survivin, CCNB1, and MYBL2), five estrogen receptor (ER) genes (ER, PGR, BCL2, and SCUBE2), two HER2 genes (HER2 and GRB7), two invasive genes (MMP11 and CTSL2), and one gene from GTSM1; and remaining five reference genes including B-Actin, GAPDH, RPLPO, TFRC, and GUS genes.…”

Section: Introductionmentioning

confidence: 99%

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The Level of Agreement Among Medical Oncologists on Adjuvant Chemotherapy Decision for Breast Cancer in Pre and Post-Oncotype DX Settings

Alkushi

Omair

Masuadi

et al. 2021

Cureus

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Introduction: The Oncotype DX assay plays an important role in the identification of the specific subset of hormone receptor (HR)-positive and node-negative breast cancer (BC) patients, who would benefit the most from adjuvant chemotherapy. The current study aimed at assessing the level of agreement among medical oncologists on adjuvant chemotherapy decisions before and after Oncotype DX, as well as the intra-observer agreement of each medical oncologist's decision of prescribing adjuvant chemotherapy based on clinicopathological and immunohistochemical parameters only and followed by Oncotype DX recurrence score (RS) results. Methods: A retrospective analysis of data related to clinicopathological and immunohistochemical parameters, and Oncotype DX RS result for 145 female, estrogen receptor (ER)-positive, HER2 negative, and both node-negative and positive BC patients was performed. Initially, the data without Oncotype DX RS was sent to 16 oncologists in multiple centers in the Middle East. After one week, the same data with the shuffling of cases were sent to the oncologists with the addition of the Oncotype DX RS result for each patient. The inter and intra-observer agreement (kappa and Fleiss multi-rater kappa) among oncologists' decision of prescribing adjuvant chemotherapy pre and post-Oncotype DX RS results were assessed. Oncotype DX risk scores were used as continuous variables as well as based on old RS grouping, categorized into low (0-17), intermediate (18-30), and high risk (≥ 31) groups. A test with a p-value of < 0 .05 will be considered statistically significant. Results: The mean age ± SD of the cohort was 51.9 ± 9.4 years. Sixty-nine patients (47.6%) were premenopausal whereas 76 patients (52.4%) were postmenopausal. The mean Oncotype DX RS was 17.8 ± 8.6 and 54.5% had low recurrence risk (RR), 37.9% had intermediate RR and only 7.6% had high RR. The majority of our cases were grade two (53.1%) and T stage one (49%), whereas 29.7% had positive one to three lymph nodes. The addition of Oncotype DX results improved the agreement among oncologists' decision from fair to moderate (kappa = 0.52; p <0.001). On average, an oncologist's decision of prescribing adjuvant chemotherapy pre and post-Oncotype DX had an agreement in 70.6% of the cases, with agreement observed mostly for cases where the initial decision of adjuvant chemotherapy was (no) and it was retained with post-Oncotype DX assay (46.1%), compared to 24.5% cases where the initial decision was (yes) and it was retained with post-Oncotype DX assay (kappa = 0.39; p <0.001). The addition of the Oncotype DX RS result avoided chemotherapy in 20.4% of cases and identified 9% of cases as candidates for adjuvant chemotherapy (kappa = 0.38; p <0.001). The disagreement was highest among cases with intermediate RR (33.6%) followed by high and low RR (31.3% and 21.6%) with a statistical significance of <0.001. Conclusion: We conclude that the Oncotype DX RS significantly influenced the decision to prescribe adjuvant chemotherapy among HR-positive, HER2 n...

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Section: Discussionsupporting

confidence: 60%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Level of Agreement Among Medical Oncologists on Adjuvant Chemotherapy Decision for Breast Cancer in Pre and Post-Oncotype DX Settings

Alkushi

Omair

Masuadi

et al. 2021

Cureus

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Systematic Characterization of p53-Regulated Long Noncoding RNAs across Human Cancers Reveals Remarkable Heterogeneity among Different Tumor Types

Regunath,

Fomin,

Liu

et al. 2024

Molecular Cancer Research

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The p53 tumor suppressor protein, a sequence specific DNA binding transcription factor, regulates the expression of a large number of genes, in response to various forms of cellular stress. While the protein coding target genes of p53 have been well studied, less is known about its role in regulating long non-coding genes and their functional relevance to cancer. Here we report the genome-wide identification of a large set (>1000) of long non-coding RNAs(lncRNAs) that are putative p53 targets in a colon cancer cell line and in human patient datasets from five different common types of cancer. These lncRNAs have not been annotated by other studies of normal unstressed systems. In the colon cancer cell line a high proportion of these lncRNAs are uniquely induced by different chemotherapeutic agents that activate p53, while others are induced by more than one agent tested. Further, subsets of these lncRNAs independently predict overall and disease-free survival of patients across the five different common cancer types. Interestingly, both genetic alterations and patient survival associated with different lncRNAs are unique to each cancer tested, indicating extraordinary tissue-specific variability in the p53 non-coding response. The newly identified non-coding p53 target genes have allowed us to construct a classifier for tumor diagnosis and prognosis. Implications: Our results not only identify myriad p53-regulated lncRNAs, they also reveal marked drug-induced, as well as tissue- and tumor-specific heterogeneity in these putative p53 targets and our findings have enabled the construction of robust classifiers for diagnosis and prognosis.

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Decisions on adjuvant chemotherapy for patients with breast cancer based on clinical and evolving Oncotype DX criteria.

Cited by 2 publications

References 0 publications

The Level of Agreement Among Medical Oncologists on Adjuvant Chemotherapy Decision for Breast Cancer in Pre and Post-Oncotype DX Settings

The Level of Agreement Among Medical Oncologists on Adjuvant Chemotherapy Decision for Breast Cancer in Pre and Post-Oncotype DX Settings

Systematic Characterization of p53-Regulated Long Noncoding RNAs across Human Cancers Reveals Remarkable Heterogeneity among Different Tumor Types

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