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The impact of Oncotype DX breast cancer assay results on clinical practice: a UK experience

Crolley, VE; Marashi, H; Rawther, S; Sirohi, B; Parton, M; Graham, J; Vinayan, A; ... King, J; + view all (2020) The impact of Oncotype DX breast cancer assay results on clinical practice: a UK experience. Breast Cancer Research and Treatment , 180 pp. 809-817. 10.1007/s10549-020-05578-6. Green open access

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Abstract

Background: Genomic tests are increasingly being used by clinicians when considering adjuvant chemotherapy for patients with oestrogen receptor-positive (ER+), human epidermal growth factor 2-negative (HER2−) breast cancer. The Oncotype DX breast recurrence score assay was the first test available in the UK National Health Service. This study looked at how UK clinicians were interpreting Recurrence Scores (RS) in everyday practice. / Methods: RS, patient and tumour characteristics and adjuvant therapy details were retrospectively collected for 713 patients from 14 UK cancer centres. Risk by RS-pathology-clinical (RSPC) was calculated and compared to the low/intermediate/risk categories, both as originally defined (RS < 18, 18–30 and > 30) and also using redefined boundaries (RS < 11, 11–25 and > 25). / Results: 49.8%, 36.2% and 14% of patients were at low (RS < 18), intermediate (RS 18–30) and high (RS > 30) risk of recurrence, respectively. Overall 26.7% received adjuvant chemotherapy. 49.2% of those were RS > 30; 93.3% of patients were RS > 25. Concordance between RS and RSPC improved when intermediate risk was defined as RS 11–25. / Conclusions: This real-world data demonstrate the value of genomic tests in reducing the use of adjuvant chemotherapy in breast cancer. Incorporating clinical characteristics or RSPC scores gives additional prognostic information which may also aid clinicians’ decision making.

Type: Article
Title: The impact of Oncotype DX breast cancer assay results on clinical practice: a UK experience
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s10549-020-05578-6
Publisher version: https://doi.org/10.1007/s10549-020-05578-6
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Breast cancer, Adjuvant chemotherapy, Early breast cancer, Biomarkers, Oncotype DX breast recurrence score assay
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: https://discovery.ucl.ac.uk/id/eprint/10110709
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