Oncotype DX, Predict, and the Nottingham Prognostic Index (NPI) – A study in decision making
Association of Breast Surgery ePoster Library. Rizki H. 05/13/19; 257135; P091
Hirah Rizki
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P091
Topic: Non surgical treatments
Introduction: The Recurrence Score (RS) generated by Oncotype DX (ODX) gene profiling predicts the 10-year disease recurrence risk for a patient with breast cancer and estimates their benefit from adjuvant chemotherapy. This study aimed to evaluate use of ODX testing in our institution and assess its impact on chemotherapy decisions. Methods This retrospective study included all ER-positive, HER2-negative, node-negative breast cancer patients treated over 12-months (2017-2018). Data collected included patient demographics, tumour pathology, NPI/Predict scores, RS and chemotherapy decisions. Data for patients selected for ODX testing were compared with patients not ODX tested using T-tests or Mann-Whitney. Spearman R's were generated for Predict/NPI correlations. Kruskal-Wallis and Chi-squared tests assessed ODX and chemotherapy decisions. Results: Of 133 eligible early breast cancer patients, 46 were selected for ODX testing. These patients were younger (P<0.0001), symptomatic (P=0.0033), with larger (P<0.0001), higher grade (P<0.0001) tumours, compared to the non-ODX teseted group. Patients with higher Predict/NPI scores were significantly more likely to undergo ODX testing (P<0.0001). A significant proportion of patients with lower NPI/Predict scores were offered chemotherapy based on their RS score (P<0.05). All patients with high RS were offered chemotherapy irrespective of NPI/Predict score. Predict strongly correlated with NPI (R, 0.91; P<0.0001) but showed lower correlation with ODX (R,0.33; P=0.0249).ConclusionNPI/Predict scores may underestimate risk compared to ODX. Patients are more likely to receive chemotherapy if ODX tested first. Therefore, we showed ODX testing changed chemotherapy decisions compared to using NPI or Predict alone.
Topic: Non surgical treatments
Introduction: The Recurrence Score (RS) generated by Oncotype DX (ODX) gene profiling predicts the 10-year disease recurrence risk for a patient with breast cancer and estimates their benefit from adjuvant chemotherapy. This study aimed to evaluate use of ODX testing in our institution and assess its impact on chemotherapy decisions. Methods This retrospective study included all ER-positive, HER2-negative, node-negative breast cancer patients treated over 12-months (2017-2018). Data collected included patient demographics, tumour pathology, NPI/Predict scores, RS and chemotherapy decisions. Data for patients selected for ODX testing were compared with patients not ODX tested using T-tests or Mann-Whitney. Spearman R's were generated for Predict/NPI correlations. Kruskal-Wallis and Chi-squared tests assessed ODX and chemotherapy decisions. Results: Of 133 eligible early breast cancer patients, 46 were selected for ODX testing. These patients were younger (P<0.0001), symptomatic (P=0.0033), with larger (P<0.0001), higher grade (P<0.0001) tumours, compared to the non-ODX teseted group. Patients with higher Predict/NPI scores were significantly more likely to undergo ODX testing (P<0.0001). A significant proportion of patients with lower NPI/Predict scores were offered chemotherapy based on their RS score (P<0.05). All patients with high RS were offered chemotherapy irrespective of NPI/Predict score. Predict strongly correlated with NPI (R, 0.91; P<0.0001) but showed lower correlation with ODX (R,0.33; P=0.0249).ConclusionNPI/Predict scores may underestimate risk compared to ODX. Patients are more likely to receive chemotherapy if ODX tested first. Therefore, we showed ODX testing changed chemotherapy decisions compared to using NPI or Predict alone.
P091
Topic: Non surgical treatments
Introduction: The Recurrence Score (RS) generated by Oncotype DX (ODX) gene profiling predicts the 10-year disease recurrence risk for a patient with breast cancer and estimates their benefit from adjuvant chemotherapy. This study aimed to evaluate use of ODX testing in our institution and assess its impact on chemotherapy decisions. Methods This retrospective study included all ER-positive, HER2-negative, node-negative breast cancer patients treated over 12-months (2017-2018). Data collected included patient demographics, tumour pathology, NPI/Predict scores, RS and chemotherapy decisions. Data for patients selected for ODX testing were compared with patients not ODX tested using T-tests or Mann-Whitney. Spearman R's were generated for Predict/NPI correlations. Kruskal-Wallis and Chi-squared tests assessed ODX and chemotherapy decisions. Results: Of 133 eligible early breast cancer patients, 46 were selected for ODX testing. These patients were younger (P<0.0001), symptomatic (P=0.0033), with larger (P<0.0001), higher grade (P<0.0001) tumours, compared to the non-ODX teseted group. Patients with higher Predict/NPI scores were significantly more likely to undergo ODX testing (P<0.0001). A significant proportion of patients with lower NPI/Predict scores were offered chemotherapy based on their RS score (P<0.05). All patients with high RS were offered chemotherapy irrespective of NPI/Predict score. Predict strongly correlated with NPI (R, 0.91; P<0.0001) but showed lower correlation with ODX (R,0.33; P=0.0249).ConclusionNPI/Predict scores may underestimate risk compared to ODX. Patients are more likely to receive chemotherapy if ODX tested first. Therefore, we showed ODX testing changed chemotherapy decisions compared to using NPI or Predict alone.
Topic: Non surgical treatments
Introduction: The Recurrence Score (RS) generated by Oncotype DX (ODX) gene profiling predicts the 10-year disease recurrence risk for a patient with breast cancer and estimates their benefit from adjuvant chemotherapy. This study aimed to evaluate use of ODX testing in our institution and assess its impact on chemotherapy decisions. Methods This retrospective study included all ER-positive, HER2-negative, node-negative breast cancer patients treated over 12-months (2017-2018). Data collected included patient demographics, tumour pathology, NPI/Predict scores, RS and chemotherapy decisions. Data for patients selected for ODX testing were compared with patients not ODX tested using T-tests or Mann-Whitney. Spearman R's were generated for Predict/NPI correlations. Kruskal-Wallis and Chi-squared tests assessed ODX and chemotherapy decisions. Results: Of 133 eligible early breast cancer patients, 46 were selected for ODX testing. These patients were younger (P<0.0001), symptomatic (P=0.0033), with larger (P<0.0001), higher grade (P<0.0001) tumours, compared to the non-ODX teseted group. Patients with higher Predict/NPI scores were significantly more likely to undergo ODX testing (P<0.0001). A significant proportion of patients with lower NPI/Predict scores were offered chemotherapy based on their RS score (P<0.05). All patients with high RS were offered chemotherapy irrespective of NPI/Predict score. Predict strongly correlated with NPI (R, 0.91; P<0.0001) but showed lower correlation with ODX (R,0.33; P=0.0249).ConclusionNPI/Predict scores may underestimate risk compared to ODX. Patients are more likely to receive chemotherapy if ODX tested first. Therefore, we showed ODX testing changed chemotherapy decisions compared to using NPI or Predict alone.
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