Impact of the 21-gene recurrence score assay compared with standard clinicopathologic guidelines in adjuvant therapy selection for node-negative, estrogen receptor-positive breast cancer
- PMID: 21537874
- DOI: 10.1245/s10434-011-1698-z
Impact of the 21-gene recurrence score assay compared with standard clinicopathologic guidelines in adjuvant therapy selection for node-negative, estrogen receptor-positive breast cancer
Abstract
Background: The development of multigene assays has proved useful in the clinical management of early-stage breast cancer. The 21-gene recurrence score (RS) assay has been shown to quantify risk of distant recurrence and predict chemotherapy benefit in node-negative and node-positive, estrogen-receptor (ER)-positive breast cancer patients. Small, single-institution series have shown that, compared with standard clinicopathologic criteria, use of RS significantly affects adjuvant chemotherapy recommendations.
Methods: We performed a retrospective review of RS use and its effect on chemotherapy recommendations in node-negative, ER-positive breast cancer patients at a tertiary care teaching hospital. Patient and tumor characteristics and adjuvant treatment information were obtained on 183 patients with RS results between January 2004 and October 2009. Risk categories were assigned based on the RS and on standard clinicopathologic criteria according to guidelines from NCCN, St. Gallen, and Adjuvant!.
Results: A total of 14 patients were excluded for negative ER status (n=2), insufficient data (n=4), inclusion in TAILORx trial (n=7), and recurrent breast cancer (n=1), leaving 169 patients in the cohort. RS use increased 3-fold over the study period (from 18% in 2004 to 50% in 2009). Tumor grade, ER status, and PR status were significantly correlated with RS category. Overall concordance between RS and NCCN, St. Gallen, and Adjuvant! was 10, 48, and 50%, respectively. Depending on the guideline used for comparison, adjuvant therapy recommendations changed with the addition of the RS in 27-74% of cases.
Conclusions: RS use is increasing, and the assay significantly reduced adjuvant chemotherapy utilization in node-negative, ER -positive breast cancer patients.
Similar articles
-
Association between standard clinical and pathologic characteristics and the 21-gene recurrence score in breast cancer patients: a population-based study.Cancer. 2008 Feb 15;112(4):731-6. doi: 10.1002/cncr.23225. Cancer. 2008. PMID: 18076012
-
Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy.BMC Cancer. 2007 Apr 12;7:63. doi: 10.1186/1471-2407-7-63. BMC Cancer. 2007. PMID: 17430582 Free PMC article.
-
Prognostic role of a multigene reverse transcriptase-PCR assay in patients with node-negative breast cancer not receiving adjuvant systemic therapy.Clin Cancer Res. 2005 May 1;11(9):3315-9. doi: 10.1158/1078-0432.CCR-04-1707. Clin Cancer Res. 2005. PMID: 15867229
-
Prediction of adjuvant chemotherapy benefit in endocrine responsive, early breast cancer using multigene assays.Breast. 2009 Oct;18 Suppl 3:S141-5. doi: 10.1016/S0960-9776(09)70290-5. Breast. 2009. PMID: 19914534 Review.
-
[Adjuvant chemotherapy of early stage breast cancer].Orv Hetil. 2010 Feb 28;151(9):344-53. doi: 10.1556/OH.2010.28824. Orv Hetil. 2010. PMID: 20159750 Review. Hungarian.
Cited by
-
Cost-effectiveness of the 21-gene recurrence score assay in the context of multifactorial decision making to guide chemotherapy for early-stage breast cancer.Genet Med. 2013 Mar;15(3):203-11. doi: 10.1038/gim.2012.119. Epub 2012 Sep 13. Genet Med. 2013. PMID: 22975761 Free PMC article.
-
Identifying Clinicopathological Factors Associated with Oncotype DX® 21-Gene Recurrence Score: A Real-World Retrospective Cohort Study of Breast Cancer Patients in Quebec City, Canada.J Pers Med. 2021 Aug 28;11(9):858. doi: 10.3390/jpm11090858. J Pers Med. 2021. PMID: 34575635 Free PMC article.
-
Comparison of Oncotype DX® Recurrence Score® with other risk assessment tools including the Nottingham Prognostic Index in the identification of patients with low-risk invasive breast cancer.Virchows Arch. 2017 Sep;471(3):321-328. doi: 10.1007/s00428-017-2184-1. Epub 2017 Jul 14. Virchows Arch. 2017. PMID: 28707056
-
Using a gene expression signature when controversy exists regarding the indication for adjuvant systemic treatment reduces the proportion of patients receiving adjuvant chemotherapy: a nationwide study.Genet Med. 2016 Jul;18(7):720-6. doi: 10.1038/gim.2015.152. Epub 2015 Nov 19. Genet Med. 2016. PMID: 26583684
-
Using the 21-gene assay from core needle biopsies to choose neoadjuvant therapy for breast cancer: A multicenter trial.J Surg Oncol. 2017 Jun;115(8):917-923. doi: 10.1002/jso.24610. Epub 2017 Apr 13. J Surg Oncol. 2017. PMID: 28407247 Free PMC article. Clinical Trial.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials