The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancer
Abstract Background Decision‐making regarding adjuvant chemotherapy for early‐stage breast cancer can be guided by genomic assays such as OncotypeDX. The concordance of expected clinical decisions guided by OncotypeDX and prognostication online tools such as PREDICT is unknown. Methods We performed...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.3088 |
| _version_ | 1818539506075172864 |
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| author | Daniel A. Goldstein Chen Mayer Tzippy Shochat Daniel Reinhorn Assaf Moore Michal Sarfaty Rinat Yerushalmi Hadar Goldvaser |
| author_facet | Daniel A. Goldstein Chen Mayer Tzippy Shochat Daniel Reinhorn Assaf Moore Michal Sarfaty Rinat Yerushalmi Hadar Goldvaser |
| author_sort | Daniel A. Goldstein |
| collection | DOAJ |
| description | Abstract Background Decision‐making regarding adjuvant chemotherapy for early‐stage breast cancer can be guided by genomic assays such as OncotypeDX. The concordance of expected clinical decisions guided by OncotypeDX and prognostication online tools such as PREDICT is unknown. Methods We performed a retrospective single‐center cohort study comprising all women with estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) negative, node negative disease, whose tumors were sent for OncotypeDX analysis. Expected decision on adjuvant chemotherapy was evaluated using OncotypeDX and using PREDICT. The concordance between these two tools was calculated. The impact on concordance of prespecified features was assessed, including age, tumor size, intensity of ER and progesterone receptor (PR), grade, Ki67 and perineural and lymphovascular invasion. Results A total of 445 women were included. Overall concordance was 75% (K = 0.284). The concordance was significantly higher for grade 1 disease compared to grade 2‐3 (93% vs 72%, P < .001), tumor ≤ 1 cm compared to >1 cm (85% vs 72%, P = .009), PR positive compared to PR negative (78% vs 58%, P < .001) and ki67 < 10% compared to ≥10% (92% vs 63%, P < .001). The intensity of ER and the presence of perineural or lymphovascular invasion had no significant impact on concordance. Conclusions Compared to PREDICT, using OncotypeDx in node negative, ER positive disease is expected to change the clinical decision in a quarter of patients. The concordance between OncotypeDx and PREDICT is influenced by pathological features. In patients with very low risk, treatment decisions may be made based solely on clinical risk assessment. |
| first_indexed | 2024-12-11T21:42:56Z |
| format | Article |
| id | doaj.art-2aa72d3a7cd34f73b89fd51468b61801 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-11T21:42:56Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-2aa72d3a7cd34f73b89fd51468b618012022-12-22T00:49:45ZengWileyCancer Medicine2045-76342020-07-019134603461210.1002/cam4.3088The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancerDaniel A. Goldstein0Chen Mayer1Tzippy Shochat2Daniel Reinhorn3Assaf Moore4Michal Sarfaty5Rinat Yerushalmi6Hadar Goldvaser7Davidoff Cancer Center Beilinson HospitalRabin Medical Center Petach‐Tikva IsraelDepartment of Pathology Sheba Medical Center Ramat Gan IsraelStatistical Consulting Unit Beilinson HospitalRabin Medical Center Petach‐Tikva IsraelDavidoff Cancer Center Beilinson HospitalRabin Medical Center Petach‐Tikva IsraelDavidoff Cancer Center Beilinson HospitalRabin Medical Center Petach‐Tikva IsraelDavidoff Cancer Center Beilinson HospitalRabin Medical Center Petach‐Tikva IsraelDavidoff Cancer Center Beilinson HospitalRabin Medical Center Petach‐Tikva IsraelDavidoff Cancer Center Beilinson HospitalRabin Medical Center Petach‐Tikva IsraelAbstract Background Decision‐making regarding adjuvant chemotherapy for early‐stage breast cancer can be guided by genomic assays such as OncotypeDX. The concordance of expected clinical decisions guided by OncotypeDX and prognostication online tools such as PREDICT is unknown. Methods We performed a retrospective single‐center cohort study comprising all women with estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) negative, node negative disease, whose tumors were sent for OncotypeDX analysis. Expected decision on adjuvant chemotherapy was evaluated using OncotypeDX and using PREDICT. The concordance between these two tools was calculated. The impact on concordance of prespecified features was assessed, including age, tumor size, intensity of ER and progesterone receptor (PR), grade, Ki67 and perineural and lymphovascular invasion. Results A total of 445 women were included. Overall concordance was 75% (K = 0.284). The concordance was significantly higher for grade 1 disease compared to grade 2‐3 (93% vs 72%, P < .001), tumor ≤ 1 cm compared to >1 cm (85% vs 72%, P = .009), PR positive compared to PR negative (78% vs 58%, P < .001) and ki67 < 10% compared to ≥10% (92% vs 63%, P < .001). The intensity of ER and the presence of perineural or lymphovascular invasion had no significant impact on concordance. Conclusions Compared to PREDICT, using OncotypeDx in node negative, ER positive disease is expected to change the clinical decision in a quarter of patients. The concordance between OncotypeDx and PREDICT is influenced by pathological features. In patients with very low risk, treatment decisions may be made based solely on clinical risk assessment.https://doi.org/10.1002/cam4.3088adjuvantbreast cancergenomic assaysoncotypepredict tool |
| spellingShingle | Daniel A. Goldstein Chen Mayer Tzippy Shochat Daniel Reinhorn Assaf Moore Michal Sarfaty Rinat Yerushalmi Hadar Goldvaser The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancer Cancer Medicine adjuvant breast cancer genomic assays oncotype predict tool |
| title | The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancer |
| title_full | The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancer |
| title_fullStr | The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancer |
| title_full_unstemmed | The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancer |
| title_short | The concordance of treatment decision guided by OncotypeDX and the PREDICT tool in real‐world early‐stage breast cancer |
| title_sort | concordance of treatment decision guided by oncotypedx and the predict tool in real world early stage breast cancer |
| topic | adjuvant breast cancer genomic assays oncotype predict tool |
| url | https://doi.org/10.1002/cam4.3088 |
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