Oncotype DX Assay Can Help Guide Adjuvant Breast Cancer Chemotherapy

Michaela Ann Dinan Ph.D. Assistant Professor in Medicine Member of Duke Cancer Institute Duke University School of MedicinMedicalResearch.com Interview with:
Michaela Ann Dinan Ph.D.

Assistant Professor in Medicine
Member of Duke Cancer Institute
Duke University School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Dinan: For many years we have known that overall, women with early stage, hormone receptor positive breast cancer show an overall survival benefit from the receipt of adjuvant chemotherapy.  However, depending on the age of the patient, we have also known that between 3 to 10% of patients appear to be truly experiencing this survival benefit and that we are treating a lot of women unnecessarily.  The use of the Oncotype DX assay has provided additional information for patients to assess who at low risk of disease progression and can forgo chemotherapy.

In this study we looked to see whether the adoption of this assay was associated with reduce rates of chemotherapy in women over the age of 65.  We found that somewhat surprisingly, there was no overall association with receipt of the assay and use of chemotherapy.  However, in women who had high risk disease, receipt of the assay was associated with reduced rates of chemotherapy use.  In patients with low risk disease, receipt of the assay was associated with increased chemotherapy use.

Medical Research: What should clinicians and patients take away from your report?

Dr. Dinan: The use of the Oncotype DX assay can be very helpful in guiding recommendations regarding adjuvant chemotherapy.  Clinicians and patients may want to consider whether or not they plan to undergo chemotherapy prior to undergoing testing, since receipt of the test may either increase or decrease the perceived benefit of chemotherapy.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Dinan: Several questions remain regarding the use of the Oncotype DX assay.  In particular, in our study we did not have access to the actual genomic risk scores of the assay and this information would be particularly helpful in assessing to what extent the test results truly influenced individual patient decisions regarding chemotherapy.  In addition, our study was limited to women over the age of 65.  The impact of Oncotype DX testing in younger women, who are overall more likely to undergo chemotherapy, may differ considerable and should also be examined.  Lastly, from a health services and policy perspective, it would be helpful to understand the implications of such testing on the overall costs of care for these patients.

Citation:

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Michaela Ann Dinan Ph.D. (2015). Oncotype DX Assay Can Help Guide Adjuvant Breast Cancer Chemotherapy 

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