Impact of Onco<i>type</i> DX testing on adjuvant treatment decisions in patients with early breast cancer: A single-center study in the United Arab Emirates

Jaafar, Hassan; Bashir, Mohamed Al; Taher, Alì; Qawasmeh, Khaled al; Jaloudi, Mohammed

doi:10.1111/ajco.12259

Cited by 20 publications

(12 citation statements)

References 31 publications

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“…Similar rates were reported in studies from different parts of the world such as Mexico (45%), Hong Kong (50.7%), United Arab Emirates (53.2%), Turkey (57%), and the United States (59%) [14][15][16][17][18].…”

Section: Discussionsupporting

confidence: 84%

“…More recently, the value of ODX assay was investigated prospectively in the TAILOR-X trial. Patients with midrange RS (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) were randomly assigned to receive either chemo-endocrine therapy or endocrine therapy alone. Results showed that ACT did not improve the outcome of these patients [6].…”

Section: Introductionmentioning

confidence: 99%

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Adjuvant Chemotherapy for Patients with Breast Cancer Based on Clinical and Evolving Oncotype DX Criteria

et al. 2020

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Introduction: Oncotype DX assay recurrence score (ODX-RS) cutoff values have recently changed after the publication of the TAILOR-X trial results. We aim to explore decisions for adjuvant chemotherapy (ACT) based on physicians' clinical assessment and the evolving ODX-RS. Methodology: Patients who underwent ODX testing after curative surgical resection of estrogen receptor positive (ER+), Her2 non-overexpressed (Her2-) and lymph node-negative (LN-) breast cancer (BC) were eligible. Management of these patients was guided by the results of the old ODX-RS-1 (< 18, 18-30, and ≥31) risk grouping. For the purpose of this study, treatment decisions were also assumed according to TAILOR-X results (ODX-RS-2). Decisions of 3 medical oncologists on ACT were solicited by blinding them to the RS to investigate concordance with ODXA RS-1 and 2 recommendations. Results: Sixty-six consecutive patients were included. Median age was 50.5 (range: 21-73) years. There was 1 male patient, and 37/65 females (56.9%) were premenopausal. Among the 3 oncologists, recommendations for ACT based on clinical assessment were discrepant in 29 (43.9%) patients. Based on majority consensus (≥2 oncologists), ACT would have been recommended to 22/41 (53.7%) and 22/46 (47.82%) patients with low-risk tumors according to ODX-RS-1 and ODX-RS-2, respectively. Compared to ODX-RS-1, ODX-RS-2 identifies 12% (46 vs. 41) more low-risk patients and 66% (20 vs. 12 patients) more high-risk patients. Conclusion: Overtreatment and discrepancies in the management of patients with ER+/ Her2-/LN-early BC can be minimized by the implementation of ODX genomic assay. Some differences in ACT recommendations exist between ODX-RS-1 and ODX-RS-2.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Adjuvant Chemotherapy for Patients with Breast Cancer Based on Clinical and Evolving Oncotype DX Criteria

et al. 2020

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“…The treatment change was 32% in a pooled meta-analysis of the previous European studies. In Ontario, Canada, the percentage was 38% [12]; Mexico, 32% [13]; Japan, 38% [14]; Hong Kong, 23.3% [15]; and United Arab Emirates, 27.7% [16].…”

Section: Discussionmentioning

confidence: 98%

Implications of the 21-gene recurrence score assay (Oncotype DX) on adjuvant treatment decisions in ER-positive early-stage breast cancer patients: experience of Kuwait Cancer Control Center

Fayaz¹,

Eissa²,

Demian³

2020

J Egypt Natl Canc Inst

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Background: The Oncotype DX is a quantitative assay of the expression of 16 tumor-related genes and 5 reference genes that predicts the potential of adjuvant chemotherapy benefit in estrogen receptor (ER)-positive early breast cancer patients. The study aims to evaluate the impact of Oncotype DX as a tool for adjuvant treatment decision of ER-positive, HER2-negative, N0/N1 early-stage breast cancer patients and to determine which clinicopathological criteria derived the greatest advantage. Results: A hundred patients at a median age of 50 years were included. TNM stage distribution was 34, 63, and 3 patients for stages I, II, and IIIA respectively. Fifty-four patients had luminal A and 46 had luminal B tumors. The recurrence score (RS) results were low, intermediate, and high risk in 54, 34, and 12 patients respectively. Before the test results, adjuvant chemoendocrine therapy (CET) was recommended for 46 patients while 54 were advised for endocrine therapy (ET). After getting the test results, 25 patients received CET (1, 12, and12 patients in the low-, intermediate-, and high-risk groups respectively) and 75 received ET. Treatment change was documented in 37 patients (8 patients from ET to CET and 29 from CET to ET; p = 0.001, McNemar test). Treatment change was significant among patients ≤ 50 years, luminal B tumors, stage II and IIIA disease, and node-positive disease. Conclusion: Oncotype DX testing resulted in significant changes in the adjuvant treatment decisions in ER-positive, HER2-negative early breast cancer particularly in the case of young, luminal B, N1, and stage II-IIIA disease.

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“…Another example for biological features influencing decision making in oncology is Onco-Type DX assay. Jaafar et al [51] reported that the use of the assay was associated with a significant change in treatment decisions and an overall reduction of chemotherapy use. Also, the Ki-67 Index, although there is no objectively established cutoff point [52][53][54], has predictive and prognostic value and is a utilized marker in clinical practice, for example, it independently improves the prediction of treatment response and prognosis in a group of breast cancer patients receiving neoadjuvant treatment [55].…”

Section: Decision-specific Characteristicsmentioning

confidence: 99%

Decision Making Criteria in Oncology

et al. 2018

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Decision making is one of the most complex skills required of an oncologist and is affected by a broad range of parameters. For example, the wide variety of treatment options, with various outcomes, side-effects and costs present challenges in selecting the most appropriate treatment. Many treatment choices are affected by limited scientific evidence, availability of therapies or patient-specific factors. In the decision making process, standardized approaches can be useful, but a multitude of criteria are relevant to this process. Thus, the aim of this review is to summarize common types of decision criteria used in oncology by focusing on 3 main categories: criteria associated with the decision maker (both patient and doctor), decision specific criteria, and the often-overlooked contextual factors. Our review aims to highlight the broad range of decision criteria in use, as well as variations in their interpretation.

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Impact of Oncotype DX testing on adjuvant treatment decisions in patients with early breast cancer: A single-center study in the United Arab Emirates

Abstract: This first decision impact study in a Middle Eastern country showed the significant effect of Oncotype DX testing on clinical practice, further demonstrating the consistent impact of such testing worldwide.

Cited by 20 publications

References 31 publications

Adjuvant Chemotherapy for Patients with Breast Cancer Based on Clinical and Evolving Oncotype DX Criteria

Adjuvant Chemotherapy for Patients with Breast Cancer Based on Clinical and Evolving Oncotype DX Criteria

Implications of the 21-gene recurrence score assay (Oncotype DX) on adjuvant treatment decisions in ER-positive early-stage breast cancer patients: experience of Kuwait Cancer Control Center

Decision Making Criteria in Oncology

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