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
Affiliations
Affiliations
- Department of Radiation Oncology, Kuwait Cancer Control Center, Kuwait.
- National Cancer Institute, Cairo University, Egypt.
- Department of Radiation Oncology, Kuwait Cancer Control Center, Kuwait. gergesattia@yahoo.com.
- National Cancer Institute, Cairo University, Egypt. gergesattia@yahoo.com.
Abstract
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.
Keywords: Adjuvant systemic treatment; Early breast cancer; Oncotype DX recurrence score.
Similar articles
Dodson A, Okonji D, Assersohn L, Rigg A, Sheri A, Turner N, Smith I, Parton M, Dowsett M.Breast Cancer Res Treat. 2018 Feb;168(1):249-258. doi: 10.1007/s10549-017-4514-z. Epub 2017 Nov 11.PMID: 29128896 Free PMC article.
Selection of neoadjuvant treatment based on the 21-GENE test results in luminal breast cancer.
Morales Murillo S, Gasol Cudos A, Veas Rodriguez J, Canosa Morales C, Melé Olivé J, Vilardell Villellas F, Sanchez Guzman DR, Iglesias Martínez E, Salud Salvia A.Breast. 2021 Apr;56:35-41. doi: 10.1016/j.breast.2021.01.001. Epub 2021 Jan 15.PMID: 33601299 Free PMC article.
Dieci MV, Guarneri V, Giarratano T, Mion M, Tortora G, De Rossi C, Gori S, Oliani C, Merlini L, Pasini F, Bonciarelli G, Griguolo G, Orvieto E, Michieletto S, Saibene T, Del Bianco P, De Salvo GL, Conte P.Oncologist. 2018 Mar;23(3):297-305. doi: 10.1634/theoncologist.2017-0322. Epub 2017 Nov 13.PMID: 29133514 Free PMC article.
Curtit E, Mansi L, Maisonnette-Escot Y, Sautière JL, Pivot X.Eur J Surg Oncol. 2017 May;43(5):921-930. doi: 10.1016/j.ejso.2016.11.016. Epub 2016 Dec 14.PMID: 28087099 Review.
Carlson JJ, Roth JA.Breast Cancer Res Treat. 2013 Aug;141(1):13-22. doi: 10.1007/s10549-013-2666-z. Epub 2013 Aug 24.PMID: 23974828 Free PMC article. Review.
Cited by
Saad Abdalla Al-Zawi A, Yin SL, Mahmood B, Jalil A, Aladili Z.Cureus. 2022 Jul 27;14(7):e27341. doi: 10.7759/cureus.27341. eCollection 2022 Jul.PMID: 36042999 Free PMC article.
Parikh PM, Bhattacharyya GS, Biswas G, Krishnamurty A, Doval D, Heroor A, Sharma S, Deshpande R, Chaturvedi H, Somashekhar SP, Babu G, Reddy GK, Sarkar D, Desai C, Malhotra H, Rohagi N, Bapna A, Alurkar SS, Krishna P, Deo SVS, Shrivastava A, Chitalkar P, Majumdar SK, Vijay D, Thoke A, Udupa KS, Bajpai J, Rath GK, Dattatreya PS, Bondarde S, Patil S.South Asian J Cancer. 2021 Dec 31;10(4):213-219. doi: 10.1055/s-0041-1742080. eCollection 2021 Dec.PMID: 34984198 Free PMC article.
Alkushi A, Omair A, Masuadi E, Alamri G, Abusanad A, Abdelhafiez N, Mohamed AE, Abulkhair O.Cureus. 2021 Feb 12;13(2):e13298. doi: 10.7759/cureus.13298.PMID: 33738150 Free PMC article.