A study of the impact of the 21‐gene breast cancer assay on the use of adjuvant chemotherapy in women with breast cancer in a Mexican public hospital

J, Bargalló; Lara, Fernando; Shaw-Dulin, Robin; Pérez-Sánchez, Víctor Manuel; Villarreal-Garza, C.; Maldonado-Martínez, Héctor Aquiles; Mohar‐Betancourt, Alejandro; Yoshizawa, Carl N.; Burke, Emily; Decker, T; Chao, Calvin

doi:10.1002/jso.23794

Cited by 33 publications

(22 citation statements)

References 24 publications

(40 reference statements)

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“…The treatment change was 32% in a pooled meta-analysis of the previous European studies. In Ontario, Canada, the percentage was 38% [12]; Mexico, 32% [13]; Japan, 38% [14]; Hong Kong, 23.3% [15]; and United Arab Emirates, 27.7% [16].…”

Section: Discussionmentioning

confidence: 98%

Implications of the 21-gene recurrence score assay (Oncotype DX) on adjuvant treatment decisions in ER-positive early-stage breast cancer patients: experience of Kuwait Cancer Control Center

Fayaz¹,

Eissa²,

Demian³

2020

J Egypt Natl Canc Inst

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Background: The Oncotype DX is a quantitative assay of the expression of 16 tumor-related genes and 5 reference genes that predicts the potential of adjuvant chemotherapy benefit in estrogen receptor (ER)-positive early breast cancer patients. The study aims to evaluate the impact of Oncotype DX as a tool for adjuvant treatment decision of ER-positive, HER2-negative, N0/N1 early-stage breast cancer patients and to determine which clinicopathological criteria derived the greatest advantage. Results: A hundred patients at a median age of 50 years were included. TNM stage distribution was 34, 63, and 3 patients for stages I, II, and IIIA respectively. Fifty-four patients had luminal A and 46 had luminal B tumors. The recurrence score (RS) results were low, intermediate, and high risk in 54, 34, and 12 patients respectively. Before the test results, adjuvant chemoendocrine therapy (CET) was recommended for 46 patients while 54 were advised for endocrine therapy (ET). After getting the test results, 25 patients received CET (1, 12, and12 patients in the low-, intermediate-, and high-risk groups respectively) and 75 received ET. Treatment change was documented in 37 patients (8 patients from ET to CET and 29 from CET to ET; p = 0.001, McNemar test). Treatment change was significant among patients ≤ 50 years, luminal B tumors, stage II and IIIA disease, and node-positive disease. Conclusion: Oncotype DX testing resulted in significant changes in the adjuvant treatment decisions in ER-positive, HER2-negative early breast cancer particularly in the case of young, luminal B, N1, and stage II-IIIA disease.

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Section: Discussionmentioning

confidence: 98%

Implications of the 21-gene recurrence score assay (Oncotype DX) on adjuvant treatment decisions in ER-positive early-stage breast cancer patients: experience of Kuwait Cancer Control Center

Fayaz¹,

Eissa²,

Demian³

2020

J Egypt Natl Canc Inst

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“…226–229 A small study of 96 patients with breast cancer treated in Mexico showed that use of the Oncotype DX changed treatment decisions for 32% of patients, a finding suggesting that its use has a meaningful impact on recommendations for adjuvant treatment. 230 Results from cost-effectiveness analyses indicated that use of the Oncotype DX assay was projected to improve rates of life expectancy when compared with the current standard of care. 231 …”

Section: Treatmentmentioning

confidence: 99%

Genomic Disparities in Breast Cancer among Latinas

Lynce¹,

Graves

Jandorf

et al. 2016

Cancer Control

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Background Breast cancer is the most common cancer diagnosed among Latinas in the United States and the leading cause of cancer-related death among this population. Latinas tend to be diagnosed at a later stage and have worse prognostic features than their non-Hispanic white counterparts. Genetic and genomic factors may contribute to observed breast cancer health disparities in Latinas. Methods We provide a landscape of our current understanding and the existing gaps that need to be filled across the cancer prevention and control continuum. Results We summarize available data on mutations in high and moderate penetrance genes for inherited risk of breast cancer and the associated literature on disparities in awareness of and uptake of genetic counseling and testing in Latina populations. We also discuss common genetic polymorphisms and risk of breast cancer in Latinas. In the treatment setting, we examine tumor genomics and pharmacogenomics in Latina patients with breast cancer. Conclusions As the US population continues to diversify, extending genetic and genomic research into this underserved and understudied population is critical. By understanding the risk of breast cancer among ethnically diverse populations, we will be better positioned to make treatment advancements for earlier stages of cancer, identify more effective and ideally less toxic treatment regimens, and increase rates of survival.

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“…In patients with early-stage, hormone receptor2positive (HR1), HER2-negative breast cancer, RS has been validated to be prognostic for distant recurrence and breast cancer2specific survival, 1,2 and predictive of chemotherapy benefit in retrospective studies of archival tissue. 1,3,4 Multiple studies have shown that the RS assay influences physician treatment recommendations for women with lymph node2positive (LN1) disease, 3,[5][6][7][8][9][10][11][12][13][14] and that those who receive treatment based on RS results have low rates of distant recurrence 15 and excellent 5-year breast cancer-specific survial. [16][17][18][19][20] In 2015, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer included use of the 21-gene assay for select patients with LN1 breast cancer (1-3 positive nodes), 21 although its use in this population preceded its inclusion.…”

Section: Introductionmentioning

confidence: 99%

Uptake of the 21-Gene Assay Among Women With Node-Positive, Hormone Receptor−Positive Breast Cancer

Roberts

Kurian

Petkov

2019

Journal of the National Comprehensive Cancer Network

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Background: This study assessed uptake of the Oncotype DX 21-gene assay over time and characterized which sociodemographic and clinical factors are associated with test uptake among women with lymph node−positive (LN+), hormone receptor−positive, HER2-negative breast cancer. Methods: Invasive breast cancer cases diagnosed in 2010 through 2013 were included from a SEER database linked to 21-gene assay results performed at Genomic Health’s Clinical Laboratory. Factors associated with 21-gene assay uptake were identified using a multivariable logistic regression model. Results: Uptake of the 21-gene assay increased over time and differed by race, socioeconomic status (SES), and age. In the multivariable model, when clinical and SES variables were controlled for, racial differences in test uptake were no longer observed. Private insurance status was associated with higher odds of 21-gene assay uptake (Medicaid vs private insurance: adjusted odds ratio, 0.86; P=.02), and high area-level SES was associated with an increased odds of uptake (quintile 5 vs 1: adjusted odds ratio, 1.6; P<.001). Demographic factors such as age and marital status influenced test uptake, and use varied greatly by geographic region. Uptake of the 21-gene assay increased over time and preceded the assay’s inclusion in the NCCN Guidelines for LN+ breast cancer. Differences in uptake by race, SES, and age have persisted over time. However, when clinical and SES variables were controlled for, racial differences in assay uptake were no longer observed. Socioeconomic variables, such as health insurance type and area-level SES, were associated with assay uptake. Conclusions: Future research should continue to document practice patterns related to the 21-gene assay. Given variation in testing associated with area-level SES, insurance coverage, and geographic region, interventions to understand and reduce differential uptake are needed to ensure equitable access to this genomic test.

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A study of the impact of the 21‐gene breast cancer assay on the use of adjuvant chemotherapy in women with breast cancer in a Mexican public hospital

Cited by 33 publications

References 24 publications

Implications of the 21-gene recurrence score assay (Oncotype DX) on adjuvant treatment decisions in ER-positive early-stage breast cancer patients: experience of Kuwait Cancer Control Center

Implications of the 21-gene recurrence score assay (Oncotype DX) on adjuvant treatment decisions in ER-positive early-stage breast cancer patients: experience of Kuwait Cancer Control Center

Genomic Disparities in Breast Cancer among Latinas

Uptake of the 21-Gene Assay Among Women With Node-Positive, Hormone Receptor−Positive Breast Cancer

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