Adjuvant treatment recommendations for patients with ER-positive/HER2-negative early breast cancer by Swiss tumor boards using the 21-gene recurrence score (SAKK 26/10).

Details

Serval ID
serval:BIB_48AD4769BDA8
Type
Article: article from journal or magazin.
Collection
Publications
Title
Adjuvant treatment recommendations for patients with ER-positive/HER2-negative early breast cancer by Swiss tumor boards using the 21-gene recurrence score (SAKK 26/10).
Journal
BMC cancer
Author(s)
Pestalozzi B.C., Tausch C., Dedes K.J., Rochlitz C., Zimmermann S., von Moos R., Winterhalder R., Ruhstaller T., Mueller A., Buser K., Borner M., Novak U., Nussbaum C.U., Seifert B., Bigler M., Bize V., Vilei S.B., Rageth C., Aebi S.
Working group(s)
Swiss Group for Clinical Cancer Research (SAKK)
ISSN
1471-2407 (Electronic)
ISSN-L
1471-2407
Publication state
Published
Issued date
13/04/2017
Peer-reviewed
Oui
Volume
17
Number
1
Pages
265
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
To evaluate the effect of Recurrence Score® results (RS; Oncotype DX® multigene assay ODX) on treatment recommendations by Swiss multidisciplinary tumor boards (TB).
SAKK 26/10 is a multicenter, prospective cohort study of early breast cancer patients: Eligibility: R0-resection, ≥10% ER+ malignant cells, HER2-, pN0/pN1a. Patients were stratified into low-risk (LR) and non-low-risk (NLR) groups based on involved nodes (0 vs 1-3) and five additional predefined risk factors. Recommendations were classified as hormonal therapy (HT) or chemotherapy plus HT (CT + HT). Investigators were blinded to the statistical analysis plan. A 5%/10% rate of recommendation change in LR/NLR groups, respectively, was assumed independently of RS (null hypotheses).
Two hundred twenty two evaluable patients from 18 centers had TB recommendations before and after consideration of the RS result. A recommendation change occurred in 45 patients (23/154 (15%, 95% CI 10-22%) in the LR group and 22/68 (32%, 95% CI 22-45%) in the NLR group). In both groups the null hypothesis could be rejected (both p < 0.001). Specifically, in the LR group, only 5/113 (4%, 95% CI 1-10%) with HT had a recommendation change to CT + HT after consideration of the RS, while 18/41 (44%, 95% CI 28-60%) of patients initially recommended CT + HT were subsequently recommended only HT. In the NLR group, 3/19 (16%, 95% CI 3-40%) patients were changed from HT to CT + HT, while 19/48 (40%, 95% CI 26-55%) were changed from CT + HT to HT.
There was a significant impact of using the RS in the LR and the NLR group but only 4% of LR patients initially considered for HT had a recommendation change (RC); therefore these patients could forgo ODX testing. A RC was more likely for NLR patients considered for HT. Patients considered for HT + CT have the highest likelihood of a RC based on RS.

Keywords
Adult, Aged, Aged, 80 and over, Antineoplastic Agents/administration & dosage, Antineoplastic Agents/therapeutic use, Breast Neoplasms/drug therapy, Breast Neoplasms/genetics, Chemotherapy, Adjuvant, Clinical Decision-Making, Cohort Studies, Female, Humans, Middle Aged, Receptor, ErbB-2/genetics, Receptors, Estrogen/genetics, Risk Assessment, Treatment Outcome, Adjuvant treatment recommendation, ER-positive early breast cancer, Multigene expression profiling, Oncotype DX, Recurrence score
Pubmed
Web of science
Open Access
Yes
Create date
27/11/2017 17:10
Last modification date
20/08/2019 13:55
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