Oncotype Dx assay and breast cancer in the United States: usage and concordance with chemotherapy
Oncotype Dx assay and breast cancer in the United States: usage and concordance with chemotherapy
复制标题
DOI：
10.1007/s10549-015-3366-7
复制
发表时间：
2015-05-01
影响因子：
3.8
通讯作者：
Harlan, Linda C.
中科院分区：
文献类型：
--
作者：
Enewold, Lindsey;Geiger, Ann M.;Harlan, Linda C.
21基因复发评分（RS）检测（Oncotype DX（TM））可预测乳腺癌复发的可能性和化疗反应性。本研究的目的是描述检测试剂盒使用的时间趋势，研究与接受检测试剂盒相关的因素，并确定检测试剂盒与治疗决策的相关性。纳入了2004年、2005年和2010年诊断为I-II期女性乳腺癌患者的随机样本，这些患者报告给国家癌症研究所的监测流行病学和最终结果计划。在2010年诊断为雌激素受体阳性（ER+）、淋巴结阴性（LN-）肿瘤的女性中，确定了与接受检测相关的因素，并估计了RS化疗的可能性。从2005年至2010年，测定使用随时间增加（ER+/LN-：8.0- 27.0%，p < 0.01; ER+/LN+：2.0- 15.7%，p = 0.09; ER-：0.2- 1.7%，p < 0.01）。接受检测与年龄较小、地区收入较低和肿瘤特征相关。在低风险（RS < 18）和高风险（RS > 30）类别的妇女中，分别有3. 3%和95. 9%接受了化疗。在中等风险组中，接受化疗的比例各不相同：12.8%（RS：18-19）、35.0%（RS：20-23）和84.0%（RS：24-30）。在研究期间，检测试剂盒的使用在指南推荐和不推荐的女性中有所增加。保险和人种/种族等因素似乎与检测试剂盒的接收无关。通过三个类别和中等风险组广泛确定的RS似乎确实影响化疗决策。
The 21-gene recurrence score (RS) assay (Oncotype DX (TM)) predicts the likelihood of breast cancer recurrence and chemotherapy responsiveness. The aims of this study were to describe temporal trends in assay usage, to investigate factors associated with the receipt of the assay and to determine how the assay is associated with treatment decisions. Random samples of stage I-II female breast cancer patients diagnosed in 2004, 2005 and 2010 as reported to the National Cancer Institute's Surveillance Epidemiology and End Results program were included. Among women diagnosed in 2010 with estrogen receptor positive (ER+), lymph node-negative (LN-) tumors, factors associated with receipt of the assay were identified and the likelihood of chemotherapy by RS was estimated. Assay usage increased over time (ER+/LN-:8.0-27.0 %, p < 0.01; ER+/LN+: 2.0-15.7 %, p = 0.09; ER-: 0.2-1.7 %, p < 0.01) from 2005 to 2010. Receipt of the assay was associated with younger age, lower area income and tumor characteristics. Among women in the low (RS < 18) and high risk (RS > 30) categories, 3.3 and 95.9 % received chemotherapy, respectively. Within the intermediate risk group the receipt of chemotherapy varied: 12.8 % (RS: 18-19), 35.0 % (RS: 20-23) and 84.0 % (RS: 24-30). During the study years, assay usage increased among women for whom the assay is and is not guideline recommended. Factors such as insurance and race/ethnicity do not appear to be associated with the receipt of the assay. The RS, as determined broadly via three categories and within the intermediate risk group, does appear to influence chemotherapy decisions.