The impact of Oncotype DX testing on breast cancer management and chemotherapy prescribing patterns in a tertiary referral centre
The impact of Oncotype DX testing on breast cancer management and chemotherapy prescribing patterns in a tertiary referral centre
复制标题
DOI：
10.1016/j.ejca.2014.08.002
复制
发表时间：
2014-11-01
影响因子：
8.4
通讯作者：
Kerin, Michael J.
中科院分区：
文献类型：
--
作者：
McVeigh, Terri Patricia;Hughes, Lauren M.;Kerin, Michael J.
导论：自从引入Oncotype DX以确定基于肿瘤基因组特征的全身复发风险以来，淋巴结阴性、(O)雌激素受体（ER）阳性乳腺癌的化疗使用发生了显著变化。目的：本研究的目的是：记录化疗使用的纵向变化，2。评估新证据对当地协议的影响。方法：进行了一项队列研究，包括2006年至2013年5月期间诊断为早期淋巴结阴性，er阳性乳腺癌的连续患者，包括一段前瞻性临床试验（试验分配个性化治疗方案（TAILORx））招募。收集有关患者人口统计学，肿瘤临床病理特征，Oncotype DX使用和复发评分以及化疗使用的数据。所有的治疗决定都是在多学科讨论后做出的，遵循指南，考虑试验方案和Oncotype DX复发评分。结果：479例连续患者纳入研究，其中241例（50%）接受了Oncotype DX检测，97例作为TAILORx临床试验的一部分。Oncotype DX检测于2007年开始试验，直到2011年10月，只有参加TAILORx的患者使用了基因组分析。从2011年10月起，根据国家癌症控制规划（NCCP）指南，在所有符合条件的患者中使用Oncotype DX。共有216例（45%）患者接受了化疗。化疗的使用与基因组分析的可用性成反比。在使用Oncotype DX的患者中，138例（57%）没有化疗。结论：本研究验证了分子检测在系统性治疗合理化中的应用。(c) 2014年作者。Elsevier Ltd.出版。
Introduction: The use of chemotherapy in node-negative, (O) Estrogen Receptor (ER)-positive breast cancer has changed significantly since the introduction of Oncotype DX to determine systemic recurrence risk based on tumour genomic signature.Aims: This study aims to1. Document longitudinal changes in chemotherapy use,2. Assess the impact of new evidence on local protocol.Methods: A cohort study was undertaken, including consecutive patients with early nodenegative, ER-positive breast cancer diagnosed between 2006 and May 2013, including a period of prospective clinical trial (Trial Assigning Individualised Options for Treatment (TAILORx)) recruitment. Data were collected regarding patient demographics, tumour clinico-pathological features, Oncotype DX use and recurrence score and chemotherapy use. All therapeutic decisions were made following multidisciplinary discussion, with adherence to guidelines and consideration of trial protocol and Oncotype DX recurrence scores.Results: 479 consecutive patients were included in the study, of whom 241 (50%) underwent Oncotype DX testing, 97 as part of the TAILORx clinical trial. Oncotype DX testing began on a trial basis in 2007 and until October 2011, only patients enrolled on TAILORx availed of genomic profiling. From October 2011, Oncotype DX was used in all eligible patients as per National Cancer Control Programme (NCCP) guidelines. A total of 216 (45%) patients received chemotherapy. The use of chemotherapy changed in inverse proportion to the availability of the genomic assay. Of those patients in whom Oncotype DX was utilised, 138 (57%) were spared chemotherapy.Conclusion: This study validates the use of molecular testing in the rationalisation of systemic therapy. (c) 2014 The Authors. Published by Elsevier Ltd.