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

Crolley, Valerie; Marashi, Husam; Rawther, S.; Parton, Marina; Graham, J.; Vinayan, A.; Sutherland, Stephanie; Rigg, Anne; Wadhawan, Anshu; Harper‐Wynne, Catherine; Spurrell, Emma; Raja, F.; King, James P.

doi:10.1093/annonc/mdx362.038

Cited by 2 publications

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“…In the vast majority of cases, the MDT recommended adjuvant chemotherapy to patients with low RS scores. This is broadly in keeping with other studies looking at treatment decisions in node‐negative breast cancer 6,18,19 …”

Section: Discussionsupporting

confidence: 86%

“…This is broadly in keeping with other studies looking at treatment decisions in node-negative breast cancer. 6,18,19 Few published studies have examined the role of Oncotype Dx testing in the node positive setting. Interim results of a UK based trial show that the decision to administer adjuvant chemotherapy changed in 74% of patients, sparing them from chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…In the landmark TAILORx trial, it was shown that ER+, HER2‐, node‐negative women with RS 0–15, and women above age 50 with RS 0–25 did not benefit from adjuvant chemotherapy with no difference in survival compared to endocrine therapy alone 5 . Multiple studies have shown the use of Oncotype DX testing in the node‐negative setting has changed treatment decisions in up to 30% of patients 6–8 …”

Section: Introductionmentioning

confidence: 99%

“…5 Multiple studies have shown the use of Oncotype DX testing in the node-negative setting has changed treatment decisions in up to 30% of patients. [6][7][8] More recently, attention has turned to the utility of the RS in node positive patients, to try to identify patients who would benefit from adjuvant chemotherapy. 9 Retrospective data from the SWOG-8814 trial found that only ER +, HER2-, node positive patients identified as high risk, which was defined as a RS >30, benefitted from the addition of adjuvant chemotherapy compared to tamoxifen alone.…”

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confidence: 99%

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The impact of Oncotype DX testing on adjuvant chemotherapy decision making in 1–3 node positive breast cancer

et al. 2021

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Background Oncotype DX testing has reduced the use of adjuvant chemotherapy in node‐negative early breast cancer but less is known about its impact in node positive patients. Aim This study aimed to investigate the impact of Oncotype DX gene assay testing on the decision to offer adjuvant chemotherapy in oestrogen positive, human epidermal growth factor receptor 2 negative, 1–3 lymph node positive patients. Methods Retrospective review of all node positive patients who underwent Oncotype DX testing at a single centre. Clinicopathological data, as well as estimated survival benefit data (from the PREDICT tool), was evaluated by a multidisciplinary group of surgeons and oncologists. Treatment decisions based on clinicopathological data were compared to recurrence scores (RS). A cut off RS > 30 was used to offer adjuvant chemotherapy. Results The 69 patients were identified, of which 9 (13%) had an RS > 30 and assigned a high‐genomic risk of recurrence. The 32 patients (46.4%) were offered adjuvant chemotherapy. Overall based on the use of the RS, the decision to offer adjuvant chemotherapy changed in 36% of patients, and ultimately 24 patients (34.7%) would have been spared chemotherapy. Conclusion Using clinicopathological data alone to make decisions regarding adjuvant chemotherapy in node positive breast cancer leads to overtreatment. Additional information on tumour biology as assessed by the Oncotype DX RS helps to select those patients who will benefit from adjuvant chemotherapy and spare patients from unnecessary chemotherapy.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%