Oncotype DX Recurrence Score Influences Treatment Decisions

ASCO—A new study indicates that the Oncotype DX Recurrence Score (RS) is being used to change treatment decisions regarding adjuvant therapy in patients with early-stage node-negative, estrogen-receptor-positive breast cancer, Shelly S. Lo, MD, said at an ASCO poster presentation (abstract 577). Dr. Lo is assistant professor of medicine, Division of Hematology/Oncology, Loyola University Chicago Stritch School of Medicine. The investigators followed 89 patients treated by 17 medical oncologists from three academic practices and one community practice. They found that knowledge of a patient's RS changed the physician's treatment recommendation 31.5% of the time, and changed the patient's treatment decision 27% of the time.

The most common change was to switch from a plan for chemotherapy plus hormonal therapy before receiving RS results to a plan for hormonal therapy alone after a low RS result was obtained (22.5% of physician recommendation changes and 10.1% of patient decision changes). Less often, the treatment decision switched from a plan for hormonal therapy alone to one for chemotherapy plus hormonal therapy after a high RS result was obtained (3.4% and 7.9%, respectively).

Three-fourths of the medical oncologists (76%) said that the RS results increased their confidence in their recommendations. Among the patients, 83% said the results influenced their treatment choice, and 95% indicated they were glad they received the test.

"Our study demonstrates that the Recurrence Score influenced treatment practice at both the academic and community hospital level, while giving patients and physicians greater confidence in their decision," said senior author Kathy S. Albain, MD, professor of medicine, Division of Hematology/Oncology, Stritch School of Medicine.