Impact of Oncotype DX Test on the use of adjuvant chemotherapy in early breast cancer over 5 years in Oxford, UK
Association of Breast Surgery ePoster Library. Mustata L. 05/13/19; 257169; P127
Laura Mustata
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P127
Topic: Other
Introduction: The decision for adjuvant chemotherapy in breast cancer is traditionally based on clinco-pathological factors; about 34% [PR1]receive it with potential short and long-term side-effects. Oncotype Dx, Gene expression profiling assay, is now used for patients with ER+, HER2-, LN-ve cancers to predict chemotherapy benefit as recommended by NICE (2013). Our MDT has been using it regularly since then and has also extended the indication for highly-selected node-positive patients. We evaluated the impact of Oncotype-DX usage on treatment recommendations over 5 years (2013-2018). Methods : Onctoype DX was carried out on 146 women with ER+, HER2-, invasive breast cancer who underwent primary surgery. The treatment recommendations were was noted in the MDT and then compared to the decision after DX testing. The impact on treatment decisions and associated cost impact were assessed. Results: In the LN negative group (n=77); 43 were recommended to have chemotherapy and hormone-therapy and 34 hormone-therapy only. The RS (recurrence score) allowed 24 women (58%) to avoid unnecessary chemotherapy and discovered 9 (26%) to benefit from chemotherapy. In the LN positive group (n=62); all were recommended chemotherapy; RS allowed 52 women (85%) to avoid it. The costs involved were compared using standard chemotherapy cost without taking into consideration the cost incurred by the hospital to manage chemotherapy complications. Conclusions: Incorporating Oncotype testing into clinical practice for node-negative and highly-selected node-positive patients, predicted to derive intermediate benefit has reduced chemotherapy use. No negative impact has been observed so far by omission of chemotherapy.
Topic: Other
Introduction: The decision for adjuvant chemotherapy in breast cancer is traditionally based on clinco-pathological factors; about 34% [PR1]receive it with potential short and long-term side-effects. Oncotype Dx, Gene expression profiling assay, is now used for patients with ER+, HER2-, LN-ve cancers to predict chemotherapy benefit as recommended by NICE (2013). Our MDT has been using it regularly since then and has also extended the indication for highly-selected node-positive patients. We evaluated the impact of Oncotype-DX usage on treatment recommendations over 5 years (2013-2018). Methods : Onctoype DX was carried out on 146 women with ER+, HER2-, invasive breast cancer who underwent primary surgery. The treatment recommendations were was noted in the MDT and then compared to the decision after DX testing. The impact on treatment decisions and associated cost impact were assessed. Results: In the LN negative group (n=77); 43 were recommended to have chemotherapy and hormone-therapy and 34 hormone-therapy only. The RS (recurrence score) allowed 24 women (58%) to avoid unnecessary chemotherapy and discovered 9 (26%) to benefit from chemotherapy. In the LN positive group (n=62); all were recommended chemotherapy; RS allowed 52 women (85%) to avoid it. The costs involved were compared using standard chemotherapy cost without taking into consideration the cost incurred by the hospital to manage chemotherapy complications. Conclusions: Incorporating Oncotype testing into clinical practice for node-negative and highly-selected node-positive patients, predicted to derive intermediate benefit has reduced chemotherapy use. No negative impact has been observed so far by omission of chemotherapy.
P127
Topic: Other
Introduction: The decision for adjuvant chemotherapy in breast cancer is traditionally based on clinco-pathological factors; about 34% [PR1]receive it with potential short and long-term side-effects. Oncotype Dx, Gene expression profiling assay, is now used for patients with ER+, HER2-, LN-ve cancers to predict chemotherapy benefit as recommended by NICE (2013). Our MDT has been using it regularly since then and has also extended the indication for highly-selected node-positive patients. We evaluated the impact of Oncotype-DX usage on treatment recommendations over 5 years (2013-2018). Methods : Onctoype DX was carried out on 146 women with ER+, HER2-, invasive breast cancer who underwent primary surgery. The treatment recommendations were was noted in the MDT and then compared to the decision after DX testing. The impact on treatment decisions and associated cost impact were assessed. Results: In the LN negative group (n=77); 43 were recommended to have chemotherapy and hormone-therapy and 34 hormone-therapy only. The RS (recurrence score) allowed 24 women (58%) to avoid unnecessary chemotherapy and discovered 9 (26%) to benefit from chemotherapy. In the LN positive group (n=62); all were recommended chemotherapy; RS allowed 52 women (85%) to avoid it. The costs involved were compared using standard chemotherapy cost without taking into consideration the cost incurred by the hospital to manage chemotherapy complications. Conclusions: Incorporating Oncotype testing into clinical practice for node-negative and highly-selected node-positive patients, predicted to derive intermediate benefit has reduced chemotherapy use. No negative impact has been observed so far by omission of chemotherapy.
Topic: Other
Introduction: The decision for adjuvant chemotherapy in breast cancer is traditionally based on clinco-pathological factors; about 34% [PR1]receive it with potential short and long-term side-effects. Oncotype Dx, Gene expression profiling assay, is now used for patients with ER+, HER2-, LN-ve cancers to predict chemotherapy benefit as recommended by NICE (2013). Our MDT has been using it regularly since then and has also extended the indication for highly-selected node-positive patients. We evaluated the impact of Oncotype-DX usage on treatment recommendations over 5 years (2013-2018). Methods : Onctoype DX was carried out on 146 women with ER+, HER2-, invasive breast cancer who underwent primary surgery. The treatment recommendations were was noted in the MDT and then compared to the decision after DX testing. The impact on treatment decisions and associated cost impact were assessed. Results: In the LN negative group (n=77); 43 were recommended to have chemotherapy and hormone-therapy and 34 hormone-therapy only. The RS (recurrence score) allowed 24 women (58%) to avoid unnecessary chemotherapy and discovered 9 (26%) to benefit from chemotherapy. In the LN positive group (n=62); all were recommended chemotherapy; RS allowed 52 women (85%) to avoid it. The costs involved were compared using standard chemotherapy cost without taking into consideration the cost incurred by the hospital to manage chemotherapy complications. Conclusions: Incorporating Oncotype testing into clinical practice for node-negative and highly-selected node-positive patients, predicted to derive intermediate benefit has reduced chemotherapy use. No negative impact has been observed so far by omission of chemotherapy.
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