Comparison of breast cancer prognostic tests CanAssist Breast and Oncotype DX

Abstract

Background CanAssist Breast (CAB) is a prognostic test for early stage hormone receptor‐positive (HR+), human epidermal growth factor receptor 2 negative (HER2−) breast cancer patients, validated on Indian and Caucasian patients. The 21‐gene signature Oncotype DX (ODX) is the most widely used commercially available breast cancer prognostic test. In the current study, risk stratification of CAB is compared with that done with ODX along with the respective outcomes of these patients. Methods A cohort of 109 early stage breast cancer patients who had previously taken the ODX test were retested with CAB, and the results respectively compared with old cut‐offs of ODX as well as cut‐offs suggested by TAILORx, a prospective randomized trial of ODX. Distant metastasis‐free survival after 5 years was taken as the end point. Results CanAssist Breast stratified 83.5% of the cohort into low‐risk and 16.5% into high‐risk. With the TAILORx cut‐offs, ODX stratified the cohort into 89.9% low‐risk and 10.1% into high‐risk. The low, intermediate, and high‐risk groups with ODX old cut‐offs were 62.4%, 31.2%, and 6.4%, respectively. The overall concordance of CAB with ODX using both cut‐offs is 75%‐76%, with ~82%‐83% concordance in the low‐risk category of these tests. The NPV of the low‐risk category of CAB was 93.4%, and of ODX with TAILORx cut‐offs was 91.8% and 89.7% with old cut‐offs. Conclusions Compared to the concordance reported for other tests, CAB shows high concordance with ODX, and in addition shows comparable performance in the patient outcomes in this cohort. CAB is thus an excellent and cost‐effective alternative to ODX.

The usefulness of CanAssist breast in the assessment of recurrence risk in patients of ethnic Indian origin

“…CanAssist Breast (CAB) was developed for bridging this gap for Asian ethnic women as a well validated and cost-effective test. Moreover, the test had 83% concordance with Oncotype DX in selecting patients at low risk of recurrence who can avoid systemic therapy despite the fact that CAB uses biomarkers which are different to that of Oncotype DX [ 12 ]. Thus, the molecular markers of CAB enable disease prognostication beyond the standard clinical parameters and markers of proliferation, hormonal indices.…”

“…CAB predicts risk of distant recurrence in 5 years from diagnosis by segregating the patients into low- and high-risk groups for distant recurrence; based on this recurrence risk prediction an informed decision can be made on use of systemic anti-cancer therapy for the patient [ 8 , 11 , 12 ].…”

Practical Consensus Recommendations for Optimizing Risk versus Benefit of Chemotherapy in Patients with HR Positive Her2 Negative Early Breast Cancer in India

“…Fortunately, CanAssist Breast is a tool that has been prospectively validated in Indian patients and results published in full-text articles in international journals of repute. 61 62 63 64 CanAssist Breast data has also been compared to Oncotype DX, Mammaprint, Ki67, and IHC4 65 …”

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“…Fortunately, CanAssist Breast is a tool that has been prospectively validated in Indian patients and results published in full-text articles in international journals of repute. [61][62][63][64] CanAssist Breast data has also been compared to Oncotype DX, Mammaprint, Ki67, and IHC4 65 Besides robust data from Indian patients, other key advantages of CanAssist Breast include clear-cut division into two risk categories (no intermediate group) and its applicability to all patients, irrespective of their age or menopausal status. In fact, real-world data consist of 589 patients from 30 cities across India treated by 180 oncologists.…”