Medical Research: What is the background for this study? What are the main findings?
Dr. Dinan: We wanted to examine how Oncotype DX® Breast Cancer Test (ODX) was being used in real-world practice at the population level. ODX has been examined in clinical trials and limited academic settings but we know that these patients are often younger, have fewer medical comorbidities, and do not necessarily accurately reflect the majority patients with cancer. In our study, we observed that Oncotype DX® Breast Cancer Test was being used predominately in accordance with guidelines which recommend the test for women with estrogen-receptor positive, node negative disease. We also looked just at women under the age of 70 who met guideline criteria for testing, because this population would include those women who were more likely to be chemotherapy candidates, and we saw a rapid uptake of the test between 2005 and 2009, with use of the test increasing from 8% to 39%.
Medical Research: What should clinicians and patients take away from your report?
Dr. Dinan: Another interesting finding of this study was the lack of variation in Oncotype DX® Breast Cancer Test use by race, geography, or, socioeconomic status. Often for emerging medical technologies, we tend to see differences in initial use for these patient populations. Our analysis did not examine why we didn’t see this differential utilization with the emergence of ODX, but clinicians and patients should be aware that the test is available to them without obvious barriers to its use in cases where it is medically indicated.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Dinan: I think it will be critical to further explore the implications of ODX testing in women with breast cancer. The ODX test helps predict which cancers will be more aggressive as well as guide recommendations as to which patients would most likely benefit from chemotherapy. I think we should look to see what impact this test is really having on the use of chemotherapy and its associated costs and outcomes for real-world breast cancer patients.
MedicalResearch.com Interview with: Dr. Michaela A. Dinan Ph.D, Department of Medicine, & Duke University (2015). Study Examines Use Of Oncotype DX® Breast Cancer Test In Medicare Patients