Researchers at the New York University School of Medicine and the US Oncology Research Network recently reported use of the Oncotype DX test to predict risk of breast cancer recurrence altered treatment decisions in 25% of patients with node-negative, estrogen receptor-positive breast cancer. These results were recently presented at the 28th annual San Antonio Breast Cancer Symposium (SABCS).
Adjuvant chemotherapy and/or hormone therapy have resulted in better survival among women with early-stage breast cancer. Because some women are at higher risk of cancer recurrence, and are more likely to benefit from these treatments than others, tests to predict risk of recurrence may allow for more individualized treatment approaches.
Oncotype DX is a test indicated for patients with newly diagnosed stage I or II, node-negative, estrogen receptor-positive breast cancer who will be treated with tamoxifen. The test evaluates a panel of 21 genes to predict a patient’s 10-year risk of cancer recurrence. The test classifies patients as being at high, intermediate, or low risk of recurrence based on a Recurrence Score.
To explore whether the Recurrence Score obtained from Oncotype DX influences treatment decisions, researchers evaluated 68 patients seen by four oncologists in a community-based oncology practice. All patients had node-negative, estrogen receptor-positive breast cancer. Oncotype DX classified 32 patients as low-risk, 22 patients as intermediate-risk, and 14 patients as high-risk.
- Information about the Oncotype DX Recurrence Score changed physician treatment recommendations in 21% of patients: Recommendation changed from chemotherapy to hormone therapy for seven patients and from hormone therapy to chemotherapy for another seven patients.
- Information about the Oncotype DX Recurrence Score changed actual treatment received in 25% of patients.
- The decision of a physician to switch a patient’s treatment from hormone therapy to chemotherapy was typically associated with a high Recurrence Score, while the decision to switch a patient’s treatment from chemotherapy to hormone therapy was typically associated with a low Recurrence Score.
The researchers concluded that Oncotype DX test results influenced treatment decisions for a large proportion of node-negative, hormone receptor-positive breast cancer patients. Results from tests such as this are likely to allow for more individualized treatment decisions.
Reference: Oratz R, Paul D, Cohn A, Sedlacek S. Impact of Onoctype DX™ Recurrence Score on Decision Making in Early-Stage Breast Cancer. Proceedings from the 28th annual San Antonio Breast Cancer Symposium. December 2005. Abstract #2049.
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