Irish national real-world analysis of the clinical and economic impact of 21-gene oncotype DX® testing in early-stage, 1-3 lymph node-positive, oestrogen receptor-positive, HER2-negative, breast cancer.

IF 3 3区医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2024-10-04 DOI:10.1007/s10549-024-07486-5

I M Browne, R A McLaughlin, C S Weadick, S O'Sullivan, L M McSorley, D K Hadi, S J Millen, M J Higgins, J P Crown, R S Prichard, D P McCartan, A Dk Hill, R M Connolly, S A Noonan, D O'Mahony, C Murray, C O'Hanlon-Brown, B T Hennessy, C M Quinn, C M Kelly, S O'Reilly, P G Morris, J M Walshe

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Abstract

Purpose: The treatment landscape of Oestrogen receptor-positive (ER-positive) breast cancer is evolving, with declining chemotherapy use as a result of Oncotype DX Breast Recurrence Score® testing. Results from the SWOG S1007 RxPONDER trial suggest that adjuvant chemotherapy may benefit some premenopausal women with ER-positive, HER2-negative disease with 1-3 positive lymph nodes (N1), and a Recurrence Score® (RS) of ≤ 25. Postmenopausal women with similar characteristics did not benefit from adjuvant chemotherapy. We examine the clinical and economic impact of Oncotype DX® testing on treatment decisions in patients with N1 disease in Ireland using real world data.

Methods: From March 2011 to October 2022, a retrospective, cross-sectional observational study was performed of patients with ER-positive, HER2-negative N1 breast cancer, who had Oncotype DX testing across 5 of Ireland's largest cancer centres. Patients were classified into low risk (RS 0-13), intermediate risk (RS 14-25) and high risk (RS > 25). Data were collected via electronic patient records. Information regarding costing was provided primarily by pre-published sources.

Results: A total of 828 N1 patients were included in this study. Post Oncotype DX testing, 480 patients (58%) were spared chemotherapy. Of the patients who had a change in chemotherapy recommendation based on Oncotype DX testing, 271 (56%), 205 (43%), 4 (1%) had a RS result of 0-13, 14-25 and > 25 respectively. Use of Oncotype DX testing was associated with a 58% reduction in chemotherapy administration overall. This resulted in estimated savings of over €6 million in treatment costs. Deducting the assay cost, estimated net savings of over €3.3 million were achieved. Changes in the ordering demographics of Oncotype DX tests were identified after RxPONDER data were presented, with increased testing in women ≥ 50 years and a reduction in proportion of tests ordered for women < 50 years.

Conclusion: Between 2011 and 2022, assay use resulted in a 58% reduction in chemotherapy administration and net savings of over €3.3 million.

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爱尔兰对 21 基因肿瘤型 DX® 检测对早期、1-3 个淋巴结阳性、雌激素受体阳性、HER2 阴性乳腺癌的临床和经济影响的全国性真实世界分析。

目的：雌激素受体阳性（ER 阳性）乳腺癌的治疗形势正在发生变化，Oncotype DX 乳房复发评分® 测试使化疗的使用率下降。SWOG S1007 RxPONDER 试验结果表明，辅助化疗可使一些ER阳性、HER2阴性、淋巴结1-3个阳性（N1）且复发评分® (RS)≤25的绝经前妇女获益。具有类似特征的绝经后妇女无法从辅助化疗中获益。我们利用真实数据研究了 Oncotype DX® 检测对爱尔兰 N1 患者治疗决策的临床和经济影响：从2011年3月到2022年10月，我们对爱尔兰5家最大的癌症中心接受Oncotype DX检测的ER阳性、HER2阴性N1乳腺癌患者进行了一项回顾性、横断面观察研究。患者被分为低风险（RS 0-13）、中风险（RS 14-25）和高风险（RS > 25）。数据通过电子病历收集。有关成本计算的信息主要由预先公布的资料来源提供：本研究共纳入了 828 名 N1 患者。经过 Oncotype DX 检测后，480 名患者（58%）免于化疗。在根据 Oncotype DX 检测结果改变化疗建议的患者中，271 人（56%）、205 人（43%）和 4 人（1%）的 RS 结果分别为 0-13、14-25 和大于 25。使用 Oncotype DX 检测后，化疗用药总体减少了 58%。据估计，这将节省超过 600 万欧元的治疗费用。扣除检测成本，估计净节省超过 330 万欧元。RxPONDER 数据公布后，Oncotype DX 检测的订购人口统计学发生了变化，≥ 50 岁女性的检测增加了，而女性订购检测的比例下降了：从 2011 年到 2022 年，化疗用药量减少了 58%，净节约超过 330 万欧元。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.