Limits...
Impact of Oncotype DX Recurrence Score on Treatment Decisions: Results of a Prospective Multicenter Study in Turkey.

Ozmen V, Atasoy A, Gokmen E, Ozdogan M, Guler N, Uras C, Ok E, Demircan O, Isikdogan A, Saip P - Cureus (2016)

Bottom Line: Each case was brought back to tumor conference after receiving the RS result.Multivariate analysis indicated that progesterone receptor (PR) and Ki-67 scores were significantly related to RS.Oncotype DX testing may provide meaningful additional information in carefully selected patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Istanbul University.

ABSTRACT

Introduction: Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX(®) 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the impact of the Recurrence Score(®) (RS) on treatment decisions and physician perceptions in Turkey. We also studied correlations between RS and routine risk factors.

Patients and methods: Ten academic centers across Turkey participated in this prospective trial. Consecutive breast cancer patients with pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at multidisciplinary tumor conferences. The initial treatment decision was recorded before tumor blocks were sent to the central laboratory. Each case was brought back to tumor conference after receiving the RS result. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classical risk factors were evaluated using univariate and multivariate analyses.

Results: Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of 165 patients, 57% had low RS, 35% had intermediate RS, and 8% had high RS, respectively. The overall rate of change in treatment decision was 33%. Initially, chemotherapy followed by hormonal therapy (CT+HT) was recommended to 92 (56%) of all patients, which decreased to 61 (37%) patients post-RS assay (p<0.001). Multivariate analysis indicated that progesterone receptor (PR) and Ki-67 scores were significantly related to RS.

Conclusion: Oncotype DX testing may provide meaningful additional information in carefully selected patients.

No MeSH data available.


Related in: MedlinePlus

Change in Treatment Decision
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4829400&req=5

FIG1: Change in Treatment Decision

Mentions: The overall rate of change in treatment decision following RS result was 33% (Figure 1). Following initial tumor conference (pre-RS assay), 92 (55.8%) patients were recommended chemotherapy followed by hormonal therapy (CT+HT), (Table 2). There was a significant decrease in this number following the post-RS assay tumor conference; the final treatment recommendation was CT+HT in 61 (37.0%) patients (McNemar test, p<0.001). Almost half (45%) of the patients who were originally recommended CT+HT were recommended HT alone after receiving the RS results. Meanwhile, among those patients for whom the initial recommendation was HT alone (n=73), 10 (13.7%) were recommended CT+HT after the discussion of the RS results. Among the patients with low and intermediate scores, the decision changed from CT+HT to HT alone in 33(78.6%) and 8(20.5%) patients, respectively. In the intermediate RS group, 12 (63.2%) patients were recommended HT alone both at pre- and post-RS assay tumor conference. The initial treatment recommendation was HT alone for 3 of the 14 patients in the high-risk RS group. Following review of RS results, all 14 patients in this group were recommended CT+HT.


Impact of Oncotype DX Recurrence Score on Treatment Decisions: Results of a Prospective Multicenter Study in Turkey.

Ozmen V, Atasoy A, Gokmen E, Ozdogan M, Guler N, Uras C, Ok E, Demircan O, Isikdogan A, Saip P - Cureus (2016)

Change in Treatment Decision
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4829400&req=5

FIG1: Change in Treatment Decision
Mentions: The overall rate of change in treatment decision following RS result was 33% (Figure 1). Following initial tumor conference (pre-RS assay), 92 (55.8%) patients were recommended chemotherapy followed by hormonal therapy (CT+HT), (Table 2). There was a significant decrease in this number following the post-RS assay tumor conference; the final treatment recommendation was CT+HT in 61 (37.0%) patients (McNemar test, p<0.001). Almost half (45%) of the patients who were originally recommended CT+HT were recommended HT alone after receiving the RS results. Meanwhile, among those patients for whom the initial recommendation was HT alone (n=73), 10 (13.7%) were recommended CT+HT after the discussion of the RS results. Among the patients with low and intermediate scores, the decision changed from CT+HT to HT alone in 33(78.6%) and 8(20.5%) patients, respectively. In the intermediate RS group, 12 (63.2%) patients were recommended HT alone both at pre- and post-RS assay tumor conference. The initial treatment recommendation was HT alone for 3 of the 14 patients in the high-risk RS group. Following review of RS results, all 14 patients in this group were recommended CT+HT.

Bottom Line: Each case was brought back to tumor conference after receiving the RS result.Multivariate analysis indicated that progesterone receptor (PR) and Ki-67 scores were significantly related to RS.Oncotype DX testing may provide meaningful additional information in carefully selected patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Istanbul University.

ABSTRACT

Introduction: Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX(®) 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the impact of the Recurrence Score(®) (RS) on treatment decisions and physician perceptions in Turkey. We also studied correlations between RS and routine risk factors.

Patients and methods: Ten academic centers across Turkey participated in this prospective trial. Consecutive breast cancer patients with pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at multidisciplinary tumor conferences. The initial treatment decision was recorded before tumor blocks were sent to the central laboratory. Each case was brought back to tumor conference after receiving the RS result. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classical risk factors were evaluated using univariate and multivariate analyses.

Results: Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of 165 patients, 57% had low RS, 35% had intermediate RS, and 8% had high RS, respectively. The overall rate of change in treatment decision was 33%. Initially, chemotherapy followed by hormonal therapy (CT+HT) was recommended to 92 (56%) of all patients, which decreased to 61 (37%) patients post-RS assay (p<0.001). Multivariate analysis indicated that progesterone receptor (PR) and Ki-67 scores were significantly related to RS.

Conclusion: Oncotype DX testing may provide meaningful additional information in carefully selected patients.

No MeSH data available.


Related in: MedlinePlus