A. Saenz de Miera (Vigo, Spain)
Hospital PovisaAuthor Of 1 Presentation
- I. Fernandez Perez (Vigo, Spain)
- S. Antolin Novoa (A Coruña, Spain)
- L. De Paz Arias (Madrid, Spain)
- L. Vazquez Tuñas (Pontevedra, Spain)
- M. Perez Lopez (A Coruña, Spain)
- S. Varela Ferreiro (Lugo, Spain)
- A. Gonzalez Quintas (A Coruña, Spain)
- C. Senin Estor (Vigo, Po, Spain)
- J. Cueva Banuelos (Santiago de Compostela, La, Spain)
- C. Hagen (Geneva, Switzerland)
- L. Inglada-Pérez (Madrid, Spain)
- D. Pereiro (Vigo, Spain)
- L. Calvo-Martinez (A Coruña, Spain)
- I. Carou (Pontevedra, Spain)
- L. Iglesias Rey (Ourense, Spain)
- A. Saenz de Miera (Vigo, Spain)
- T. García-Caballero (Santiago de Compostela, Spain)
60P - Real-Life Use of Oncotype DX Breast Recurrence Score® Test for the Management of Patients with Node-Negative and Node-Positive Breast Cancer in the Autonomous Community of Galicia (Spain).
Abstract
Background
Oncotype DX® is a 21-gene assay to guide adjuvant treatment decisions in HR+, HER2- early stage breast cancer. The aim of the study was to evaluate the impact of Recurrence Score® (RS) on decision-making (% change in treatment recommendation), to assess real-life utilization of Oncotype DX test in node-negative, micrometastases, and 1-3 positive lymph nodes patients.
Methods
Data from 630 patients (N0=401, N1=229) from 9 Institutions in the autonomous community of Galicia between May 2013 and Oct 2018 were collected and retrospectively analyzed in accordance with the study objectives. The majority of these data were collected prior to the publication of TAILORx and/or RxPONDER.
Results
Median age: 56 y; 77% of patients were > 50 years; 31% of patients were premenopausal, 50% postmenopausal, and 19% perimenopausal. Tumor size : pT1a-b 21%, pT1c 59%, pT2 19%, pT3 1%; Grade: G1 23%, G2 68%, G3 9%; Ki 67 <10% 20,7%, 10%-20% 39,2%, >20% 40,1%; Luminal subtype (based on Ki 67 and PR status): luminal A 75% and luminal B 25%. Nodal status: N1: 35.7% and N0: 64.3% Recurrence Score results distribution in N+ population was: RS <17: 63%, RS 17-31: 34.5%, and RS >31: 2.5%), and in N0 population: RS ≤ 25: 82.5% and RS >25: 17.4%. Changes in treatment decision are reported in the table. CT: chemotherapy, HT: hormonotherapy.
Before RS After RS % REDUCTION CT All patients n=630 HT 317 (50.3%) HT 454 (71.6%) HT+CT 313 (49.7%) HT+CT 176 (28.4%) 43.8% N0 n=401 HT 245 (61.0%) HT 284 (70.8%) HT+CT 156 (39.0%) HT+CT 117 (29.1%) 25.0% N1 n=229 HT 70 (30.6%) HT 170 (74.2%) HT+CT 159 (69.4%) HT+CT 59 (25.8%) 63.0%
Conclusions
Based on RS results, a major change in therapeutic decision occurs in patients diagnosed with breast cancer, and chemotherapy recommendations changed in a substantial proportion of patients. In N0 patients, following the outcome of RS results, the indication of chemotherapy was decreased by 25%. In N1 patients, the chemotherapy indication is dramatically reduced by 63%. Our results confirmed in real clinical life the utility of the Oncotype DX assay to guide chemotherapy treatment decisions, and provided additional support for its use both in N0 and N1 patients based on TAILORx and RxPONDER studies.
Legal entity responsible for the study
The authors.
Funding
Genomic Health International.
Disclosure
I. Fernandez-Perez: Speaker Bureau/Expert testimony: Genomic Health; Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche; Speaker Bureau/Expert testimony: Pfizer; Speaker Bureau/Expert testimony: AstraZeneka; Advisory/Consultancy: GSK. L. De Paz Arias: Advisory/Consultancy, Speaker Bureau/Expert testimony: Pfizer; Advisory/Consultancy, Speaker Bureau/Expert testimony: Lilly; Speaker Bureau/Expert testimony: Roche; Speaker Bureau/Expert testimony: Novartis. L. Vazquez Tuñas: Speaker Bureau/Expert testimony: Roche; Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis; Speaker Bureau/Expert testimony: Clovis; Speaker Bureau/Expert testimony: PharmaMar; Speaker Bureau/Expert testimony: Pfizer; Advisory/Consultancy: GSK; Advisory/Consultancy: Leo Pharma. S. Varela Ferreiro: Advisory/Consultancy, Speaker Bureau/Expert testimony: GSK; Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis; Speaker Bureau/Expert testimony: AstraZeneca; Speaker Bureau/Expert testimony: PharmaMar; Speaker Bureau/Expert testimony: Pfizer. A.Q. Gonzalez Quintas: Speaker Bureau/Expert testimony: Pfizer. J.F. Cueva Banuelos: Advisory/Consultancy: Clovis; Advisory/Consultancy, Speaker Bureau/Expert testimony: AstraZeneca; Speaker Bureau/Expert testimony: Pfizer; Advisory/Consultancy, Speaker Bureau/Expert testimony: PharmaMar; Speaker Bureau/Expert testimony: Palex; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Roche; Speaker Bureau/Expert testimony: GSK; Speaker Bureau/Expert testimony: Novartis; Advisory/Consultancy, Speaker Bureau/Expert testimony: Lilly; Speaker Bureau/Expert testimony: Eisai; Speaker Bureau/Expert testimony: Celgene; Speaker Bureau/Expert testimony: Pierre Fabre. C. Hagen: Full/Part-time employment, Officer/Board of Directors: Genomic Health. L. Inglada-Pérez: Full/Part-time employment: Genomic Health. L. Iglesias Rey: Speaker Bureau/Expert testimony: Roche; Speaker Bureau/Expert testimony: Novartis; Speaker Bureau/Expert testimony: Bristol-Myers Squibb; Speaker Bureau/Expert testimony: Pfizer; Speaker Bureau/Expert testimony: Bristol-Myers Squibb; Speaker Bureau/Expert testimony: Merck; Advisory/Consultancy: Leo Pharma; Speaker Bureau/Expert testimony: Rovi. All other authors have declared no conflicts of interest.