A decision impact, decision conflict and economic assessment of routine Oncotype DX testing of 146 women with node-negative or pNImi, ER-positive breast cancer in the U.K.
A decision impact, decision conflict and economic assessment of routine Oncotype DX testing of 146 women with node-negative or pNImi, ER-positive breast cancer in the U.K.
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DOI：
10.1038/bjc.2013.207
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发表时间：
2013-06-11
影响因子：
8.8
通讯作者：
Phillips CJ
中科院分区：
文献类型：
--
作者：
Holt S;Bertelli G;Humphreys I;Valentine W;Durrani S;Pudney D;Rolles M;Moe M;Khawaja S;Sharaiha Y;Brinkworth E;Whelan S;Jones S;Bennett H;Phillips CJ
肿瘤基因表达分析有助于预测早期乳腺癌患者辅助化疗的益处。这项研究旨在检查英国常规的Oncotype DX检测的含义。雌激素受体阳性(ER+)、pNO或pN1mi乳腺癌的妇女接受了辅助化疗评估，随后进行了肿瘤型DX测试，并记录了化疗决定的变化。一部分患者在测试前和测试后完成了关于他们对化疗决定的不确定性的问卷调查。所有患者都被要求在接下来的6个月里完成一份医疗互动的日记，从中提取经济数据来模拟测试的成本效益。肿瘤型DX检测导致142名女性中的38名(26.8%)改变了化疗决定，57名女性中有26名(45.6%)没有接受化疗，85名女性中有12名(14.1%)在最初没有推荐的情况下需要化疗(总体减少了9.9%)。决策冲突分析显示，Oncotype DX测试增加了患者对治疗决策的信心。经济分析表明，常规的Oncotype DX检测每增加一个质量调整寿命年的成本为6232 GB。在ER+早期乳腺癌患者中，Oncotype DX减少了化疗的使用，增加了对治疗决策的信心。基于这些发现，Oncotype DX在英国的环境下是具有成本效益的。
Tumour gene expression analysis is useful in predicting adjuvant chemotherapy benefit in early breast cancer patients. This study aims to examine the implications of routine Oncotype DX testing in the UK. Women with oestrogen receptor positive (ER+), pNO or pN1mi breast cancer were assessed for adjuvant chemotherapy and subsequently offered Oncotype DX testing, with changes in chemotherapy decisions recorded. A subset of patients completed questionnaires about their uncertainties regarding chemotherapy decisions pre- and post-testing. All patients were asked to complete a diary of medical interactions over the next 6 months, from which economic data were extracted to model the cost-effectiveness of testing. Oncotype DX testing resulted in changes in chemotherapy decisions in 38 of 142 (26.8%) women, with 26 of 57 (45.6%) spared chemotherapy and 12 of 85 (14.1%) requiring chemotherapy when not initially recommended (9.9% reduction overall). Decision conflict analysis showed that Oncotype DX testing increased patients' confidence in treatment decision making. Economic analysis showed that routine Oncotype DX testing costs £6232 per quality-adjusted life year gained. Oncotype DX decreased chemotherapy use and increased confidence in treatment decision making in patients with ER+ early-stage breast cancer. Based on these findings, Oncotype DX is cost-effective in the UK setting.
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DOI：
10.1093/annonc/mds512
发表时间：
2013-03
期刊：
Annals of oncology : official journal of the European Society for Medical Oncology
影响因子：
--
作者：
Eiermann W;Rezai M;Kümmel S;Kühn T;Warm M;Friedrichs K;Schneeweiss A;Markmann S;Eggemann H;Hilfrich J;Jackisch C;Witzel I;Eidtmann H;Bachinger A;Hell S;Blohmer J
通讯作者：
Blohmer J
影响因子：
3.1
作者：
Johnsson, Aina;Fornander, Tommy;Olsson, Mariann
通讯作者：
Olsson, Mariann
影响因子：
45.3
作者：
Lo, Shelly S.;Mumby, Patricia B.;Albain, Kathy S.
通讯作者：
Albain, Kathy S.
影响因子：
4.4
作者：
Milne, RJ;Heaton-Brown, KH;Cubitt, A
通讯作者：
Cubitt, A
影响因子：
51.1
作者：
Albain, Kathy S.;Barlow, William E.;Shak, Steven;Hortobagyi, Gabriel N.;Livingston, Robert B.;Yeh, I-Tien;Ravdin, Peter;Bugarini, Roberto;Boehner, Frederick L.;Davidson, Nancy E.;Sledge, George W.;Winer, Eric P.;Hudis, Clifford;Ingle, James N.;Perez, Edith A.;Pritchard, Kathleen I.;Shepherd, Lois;Gralow, Julie R.;Yoshizawa, Carl;Allred, D. Craig;Osborne, C. Kent;Hayes, Daniel F.
通讯作者：
Hayes, Daniel F.