Has the Oncotype DX Breast Cancer Assay influenced the use of chemotherapy? - The Warwick experience
Association of Breast Surgery ePoster Library. Khan M. 05/15/17; 166299; P012
Mr. Mashuk Khan
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Abstract
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Introduction
The Oncotype DX (ONDX) Breast Cancer Assay recurrence score provides a marker for risk of distant recurrence and therefore the benefit of chemotherapy in oestrogen receptor positive early breast cancer. A European systematic review suggested a net reduction in chemotherapy usage of 21%. The aim of this study was to determine if since the introduction of ONDX there had been a change in chemotherapy use based on the recurrence risk score (RRS).
Methods
Consecutive patients that had undergone ONDX were reviewed. Chemotherapy recommendations were made in an MDT without RRSs of patients. The same patients were reassessed in the MDT with the RRS treatment recommendations and the differences analysed. Wilcoxon Sign Ranks test was used for analysis
Results
76 patients were identified from our ONDX database between Feb 2012 and Nov 2016. 9 patients were excluded due to lack of data (n=67). Median age was 51 (range = 34-71). Without RRSs, 56 patients were recommended for chemotherapy (84%) and 3 did not warrant chemotherapy. The remaining 8 patients did not receive a definitive outcome but were referred for discussion. With RRSs, 34 patients were recommended for chemotherapy (50%). 24/56 patients (43%) were spared chemotherapy (p<0.0005). 1 patient was offered chemotherapy following an unexpectedly high RSS.
Conclusions
There has been a significant reduction in the use of chemotherapy in patients at Warwick since the introduction of ONDX. This reduction is higher than expected, relative to published literature. There is likely to be a significant healthcare cost reduction as a consequence.
The Oncotype DX (ONDX) Breast Cancer Assay recurrence score provides a marker for risk of distant recurrence and therefore the benefit of chemotherapy in oestrogen receptor positive early breast cancer. A European systematic review suggested a net reduction in chemotherapy usage of 21%. The aim of this study was to determine if since the introduction of ONDX there had been a change in chemotherapy use based on the recurrence risk score (RRS).
Methods
Consecutive patients that had undergone ONDX were reviewed. Chemotherapy recommendations were made in an MDT without RRSs of patients. The same patients were reassessed in the MDT with the RRS treatment recommendations and the differences analysed. Wilcoxon Sign Ranks test was used for analysis
Results
76 patients were identified from our ONDX database between Feb 2012 and Nov 2016. 9 patients were excluded due to lack of data (n=67). Median age was 51 (range = 34-71). Without RRSs, 56 patients were recommended for chemotherapy (84%) and 3 did not warrant chemotherapy. The remaining 8 patients did not receive a definitive outcome but were referred for discussion. With RRSs, 34 patients were recommended for chemotherapy (50%). 24/56 patients (43%) were spared chemotherapy (p<0.0005). 1 patient was offered chemotherapy following an unexpectedly high RSS.
Conclusions
There has been a significant reduction in the use of chemotherapy in patients at Warwick since the introduction of ONDX. This reduction is higher than expected, relative to published literature. There is likely to be a significant healthcare cost reduction as a consequence.
Introduction
The Oncotype DX (ONDX) Breast Cancer Assay recurrence score provides a marker for risk of distant recurrence and therefore the benefit of chemotherapy in oestrogen receptor positive early breast cancer. A European systematic review suggested a net reduction in chemotherapy usage of 21%. The aim of this study was to determine if since the introduction of ONDX there had been a change in chemotherapy use based on the recurrence risk score (RRS).
Methods
Consecutive patients that had undergone ONDX were reviewed. Chemotherapy recommendations were made in an MDT without RRSs of patients. The same patients were reassessed in the MDT with the RRS treatment recommendations and the differences analysed. Wilcoxon Sign Ranks test was used for analysis
Results
76 patients were identified from our ONDX database between Feb 2012 and Nov 2016. 9 patients were excluded due to lack of data (n=67). Median age was 51 (range = 34-71). Without RRSs, 56 patients were recommended for chemotherapy (84%) and 3 did not warrant chemotherapy. The remaining 8 patients did not receive a definitive outcome but were referred for discussion. With RRSs, 34 patients were recommended for chemotherapy (50%). 24/56 patients (43%) were spared chemotherapy (p<0.0005). 1 patient was offered chemotherapy following an unexpectedly high RSS.
Conclusions
There has been a significant reduction in the use of chemotherapy in patients at Warwick since the introduction of ONDX. This reduction is higher than expected, relative to published literature. There is likely to be a significant healthcare cost reduction as a consequence.
The Oncotype DX (ONDX) Breast Cancer Assay recurrence score provides a marker for risk of distant recurrence and therefore the benefit of chemotherapy in oestrogen receptor positive early breast cancer. A European systematic review suggested a net reduction in chemotherapy usage of 21%. The aim of this study was to determine if since the introduction of ONDX there had been a change in chemotherapy use based on the recurrence risk score (RRS).
Methods
Consecutive patients that had undergone ONDX were reviewed. Chemotherapy recommendations were made in an MDT without RRSs of patients. The same patients were reassessed in the MDT with the RRS treatment recommendations and the differences analysed. Wilcoxon Sign Ranks test was used for analysis
Results
76 patients were identified from our ONDX database between Feb 2012 and Nov 2016. 9 patients were excluded due to lack of data (n=67). Median age was 51 (range = 34-71). Without RRSs, 56 patients were recommended for chemotherapy (84%) and 3 did not warrant chemotherapy. The remaining 8 patients did not receive a definitive outcome but were referred for discussion. With RRSs, 34 patients were recommended for chemotherapy (50%). 24/56 patients (43%) were spared chemotherapy (p<0.0005). 1 patient was offered chemotherapy following an unexpectedly high RSS.
Conclusions
There has been a significant reduction in the use of chemotherapy in patients at Warwick since the introduction of ONDX. This reduction is higher than expected, relative to published literature. There is likely to be a significant healthcare cost reduction as a consequence.
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