Oncotype DX TM Predicts Benefit from Adjuvant Chemotherapy in Women with Early Breast Cancer at Intermediate Risk of Distant Recurrence
Association of Breast Surgery ePoster Library. Harvey K. 05/15/17; 166347; P178
Ms. Kate Harvey
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Abstract
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Introduction:
Not all women with primary breast cancer benefit equally from adjuvant chemotherapy. Selecting who to treat from those considered at intermediate risk of recurrence is challenging. Oncotype DXTM is a clinically validated genomic assay which evaluates 21 genes to assess tumour biology. It is validated to predict individual risk of distant recurrence at 10 years and is NICE approved.
Methods:
Prospective databases and electronic records were used to collect information about women tested for Oncotype DXTM. Those predicted to get intermediate benefit from chemotherapy were tested between February 2013 and October 2016.
Results:
63 women were tested, 51 node negative, 12 with micro-metastases. 17 women (27.0%) were recommended chemotherapy based on recurrence scores, all were node negative. Fewer women under 40 were tested but a higher proportion of those tested were recommended chemotherapy (60%.) 50% (9/18) of women tested with tumours 11-19mm and 33.3% (1/3) of women with tumours 10mm or less were recommended chemotherapy compared to 11.1% (1/9) of 26-40mm tumours and none with tumours >40mm (n=8). 60.9% (14/23) of women tested with grade 3 tumours were recommended chemotherapy compared to 8.1% (3/37) of grade 2 and none with grade 1 tumours.
Conclusions:
Oncotype DXTM is an independent predictor of benefit from chemotherapy irrespective of factors such as size and nodal status. 27% of women were offered systemic chemotherapy in this cohort compared to 80% in the absence of genomic testing. The test cost was offset by reduced chemotherapy cost, making it cost-effective for the intermediate risk group
Not all women with primary breast cancer benefit equally from adjuvant chemotherapy. Selecting who to treat from those considered at intermediate risk of recurrence is challenging. Oncotype DXTM is a clinically validated genomic assay which evaluates 21 genes to assess tumour biology. It is validated to predict individual risk of distant recurrence at 10 years and is NICE approved.
Methods:
Prospective databases and electronic records were used to collect information about women tested for Oncotype DXTM. Those predicted to get intermediate benefit from chemotherapy were tested between February 2013 and October 2016.
Results:
63 women were tested, 51 node negative, 12 with micro-metastases. 17 women (27.0%) were recommended chemotherapy based on recurrence scores, all were node negative. Fewer women under 40 were tested but a higher proportion of those tested were recommended chemotherapy (60%.) 50% (9/18) of women tested with tumours 11-19mm and 33.3% (1/3) of women with tumours 10mm or less were recommended chemotherapy compared to 11.1% (1/9) of 26-40mm tumours and none with tumours >40mm (n=8). 60.9% (14/23) of women tested with grade 3 tumours were recommended chemotherapy compared to 8.1% (3/37) of grade 2 and none with grade 1 tumours.
Conclusions:
Oncotype DXTM is an independent predictor of benefit from chemotherapy irrespective of factors such as size and nodal status. 27% of women were offered systemic chemotherapy in this cohort compared to 80% in the absence of genomic testing. The test cost was offset by reduced chemotherapy cost, making it cost-effective for the intermediate risk group
Introduction:
Not all women with primary breast cancer benefit equally from adjuvant chemotherapy. Selecting who to treat from those considered at intermediate risk of recurrence is challenging. Oncotype DXTM is a clinically validated genomic assay which evaluates 21 genes to assess tumour biology. It is validated to predict individual risk of distant recurrence at 10 years and is NICE approved.
Methods:
Prospective databases and electronic records were used to collect information about women tested for Oncotype DXTM. Those predicted to get intermediate benefit from chemotherapy were tested between February 2013 and October 2016.
Results:
63 women were tested, 51 node negative, 12 with micro-metastases. 17 women (27.0%) were recommended chemotherapy based on recurrence scores, all were node negative. Fewer women under 40 were tested but a higher proportion of those tested were recommended chemotherapy (60%.) 50% (9/18) of women tested with tumours 11-19mm and 33.3% (1/3) of women with tumours 10mm or less were recommended chemotherapy compared to 11.1% (1/9) of 26-40mm tumours and none with tumours >40mm (n=8). 60.9% (14/23) of women tested with grade 3 tumours were recommended chemotherapy compared to 8.1% (3/37) of grade 2 and none with grade 1 tumours.
Conclusions:
Oncotype DXTM is an independent predictor of benefit from chemotherapy irrespective of factors such as size and nodal status. 27% of women were offered systemic chemotherapy in this cohort compared to 80% in the absence of genomic testing. The test cost was offset by reduced chemotherapy cost, making it cost-effective for the intermediate risk group
Not all women with primary breast cancer benefit equally from adjuvant chemotherapy. Selecting who to treat from those considered at intermediate risk of recurrence is challenging. Oncotype DXTM is a clinically validated genomic assay which evaluates 21 genes to assess tumour biology. It is validated to predict individual risk of distant recurrence at 10 years and is NICE approved.
Methods:
Prospective databases and electronic records were used to collect information about women tested for Oncotype DXTM. Those predicted to get intermediate benefit from chemotherapy were tested between February 2013 and October 2016.
Results:
63 women were tested, 51 node negative, 12 with micro-metastases. 17 women (27.0%) were recommended chemotherapy based on recurrence scores, all were node negative. Fewer women under 40 were tested but a higher proportion of those tested were recommended chemotherapy (60%.) 50% (9/18) of women tested with tumours 11-19mm and 33.3% (1/3) of women with tumours 10mm or less were recommended chemotherapy compared to 11.1% (1/9) of 26-40mm tumours and none with tumours >40mm (n=8). 60.9% (14/23) of women tested with grade 3 tumours were recommended chemotherapy compared to 8.1% (3/37) of grade 2 and none with grade 1 tumours.
Conclusions:
Oncotype DXTM is an independent predictor of benefit from chemotherapy irrespective of factors such as size and nodal status. 27% of women were offered systemic chemotherapy in this cohort compared to 80% in the absence of genomic testing. The test cost was offset by reduced chemotherapy cost, making it cost-effective for the intermediate risk group
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