Real-world analysis of clinical and economic impact of 21-gene recurrence score (RS) testing in early-stage breast cancer (ESBC) in Ireland

McSorley, Lynda; Tharmabala, Mehala; Rahbi, Fathiya Al; McSorley, K; Chew, Sonya; Evoy, Denis; Geraghty, James; Prichard, Ruth; Rothwell, Jane; McCartan, Damian; McDermott, Enda; Keane, Maccon M.; Kennedy, Michael J.; O’Reilly, Seamus; Millen, Steve; Crown, John; Smyth, Lillian M.; Kelly, Catherine M.; Quinn, Cecily; Walshe, Janice

doi:10.1007/s10549-021-06211-w

Cited by 9 publications

(5 citation statements)

References 43 publications

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“…The use of RS testing with the modified RS groups resulted in a 75% reduction in chemotherapy administration in this study. In our previously published work analysing a larger dataset with predominantly invasive ductal carcinoma, we found a 62.5% change in chemotherapy recommendation [ 13 ]. The TAILOR-x trial confirmed that patients aged >50 years with a RS ≤ 25 do not benefit from the addition of chemotherapy to endocrine therapy and may be effectively treated with ET alone.…”

Section: Discussionmentioning

confidence: 92%

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Real-World Analysis of the Clinical and Economic Impact of the 21-Gene Recurrence Score (RS) in Invasive Lobular Early-Stage Breast Carcinoma in Ireland

McSorley,

Tharmabala,

Al Rahbi

et al. 2024

Current Oncology

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Background: This study, using real-world data, assesses the impact of RS testing on treatment pathways and the associated economic consequences of such testing. This paper pertains to lobular breast cancer. Methods: A retrospective, observational study was undertaken between 2011 and 2019 on a cross-section of hormone receptor-positive (HR+), HER2-negative, lymph node-negative, early-stage breast cancer patients. All patients had ILC and had RS testing in Ireland. The patient population is representative of the national population. Patients were classified as low (RS ≤ 25) or high (RS > 25) risk. Patients aged ≤50 were stratified as low (RS 0–15), intermediate (RS 16–25), or high risk (RS > 25). Results: A total of 168 patients were included, most of whom had grade 2 (G2) tumors (n = 154, 92%). Overall, 155 patients (92.3%) had low RS (≤25), 12 (7.1%) had high RS (>25), and 1 (0.6%) had unknown RS status. In 29 (17.5%) patients aged ≤50 at diagnosis, RS was ≤15 in 16 (55%), 16–20 in 6 (21%), 21–25 in 5 (17%), >25 in 1 (3.5%), and unknown in 1 (3.5%). Post RS testing, 126 patients (78%) had a change in chemotherapy recommendation; all to hormone therapy. In total, only 35 patients (22%) received chemotherapy. RS testing achieved a 75% reduction in chemotherapy use, resulting in savings of €921,543.84 in treatment costs, and net savings of €387,283.84. Conclusions: The use of this test resulted in a 75% reduction in chemotherapy and a significant cost savings in our publicly funded health system.

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Section: Discussionmentioning

confidence: 92%

“…Chemotherapy details recorded included regimen type and number of cycles. Patients ≤50 years old were stratified into low RS (0–15), intermediate RS [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ], and high RS (>25) risk groups based on Tailor X groupings [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

Real-World Analysis of the Clinical and Economic Impact of the 21-Gene Recurrence Score (RS) in Invasive Lobular Early-Stage Breast Carcinoma in Ireland

McSorley,

Tharmabala,

Al Rahbi

et al. 2024

Current Oncology

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“…The decision impact of the RS test was also shown across a number of UK and EU based studies which compared post-test chemotherapy decisions with a hypothetical pre-test decision [ [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ]. A change in treatment was found across all of these studies, suggesting an impact of genomic testing as a decision tool in determining chemotherapy administration.…”

Section: Introductionmentioning

confidence: 92%

“…A large study by L. M. McSorley et al assessing the experience of the RS test across Ireland was published recently [ 29 ]. They included 963 patients between October 2011 and February 2019 who were node negative and hormone receptor positive, and had the RS test, were analysed.…”

Section: Introductionmentioning

confidence: 99%

Enhancing clinical decision support with genomic tools in breast cancer: A Scottish perspective

Peters,

Hall,

Jordan

et al. 2024

The Breast

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“…1 In the context of early-stage breast cancer care, too little treatment can result in potentially preventable relapse, whilst too much treatment can result in impaired quality of survival and excessive treatment related toxicity. 2,3 Adjuvant chemotherapy in early-stage breast cancer was initially developed by Bonadonna and colleagues to improve breast cancer outcomes after surgery. 4 Multiple cycles of poly-chemotherapy regimens such as docetaxel-cyclophosphamide (TC) are now commonly used.…”

Section: Introductionmentioning

confidence: 99%

Breeching “The Goldilocks Zone”: Tetraplegia as a Rare Life-Altering Infective Complication of Adjuvant Breast Cancer Chemotherapy

et al. 2022

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Background: Adjuvant chemotherapy has been an integral component of breast cancer care for decades. Advances in supportive care have been made, but despite this, infective complications of therapy remain a significant toxicity concern. Case Presentation: A premenopausal patient presented to the emergency department during the third wave of the Covid-19 pandemic with sepsis after a second course of adjuvant docetaxel-cyclophosphamide chemotherapy. Overnight she developed tetraplegia. An urgent MRI cervical spine revealed a pre-vertebral, vertebral, and epidural abscess. This was treated with an emergency C4-C7 posterior cervical laminectomy and decompression. Her inpatient care involved a protracted ICU admission followed by rehabilitation. She remains tetraplegic and requires continued inpatient care over a year after presentation. Restricted pandemic-related hospital visiting has compounded the impact of her illness. Conclusion: Infective complications of adjuvant breast cancer chemotherapy remain an issue despite advances in supportive care. This case highlights the devastating, life-altering impact that these complications can have as emphasized by the inclusion of the patient’s perspective.

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Real-world analysis of clinical and economic impact of 21-gene recurrence score (RS) testing in early-stage breast cancer (ESBC) in Ireland

Cited by 9 publications

References 43 publications

Real-World Analysis of the Clinical and Economic Impact of the 21-Gene Recurrence Score (RS) in Invasive Lobular Early-Stage Breast Carcinoma in Ireland

Real-World Analysis of the Clinical and Economic Impact of the 21-Gene Recurrence Score (RS) in Invasive Lobular Early-Stage Breast Carcinoma in Ireland

Enhancing clinical decision support with genomic tools in breast cancer: A Scottish perspective

Breeching “The Goldilocks Zone”: Tetraplegia as a Rare Life-Altering Infective Complication of Adjuvant Breast Cancer Chemotherapy

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