The Clinical Impact of 21-Gene Recurrence Score on Treatment Decisions for Patients with Hormone Receptor-Positive Early Breast Cancer in Korea
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Purpose The 21-gene (Oncotype DX) recurrence score (RS) assay is useful in predicting the benefitsof adjuvant chemotherapy for early breast cancer patients and is widely used in Westerncountries. However, to date, it has not gained much popularity in East Asia. We analyzedthe results from five institutions’ experience from using the 21-gene assay and examinedthe impact of assay results on decision making of chemotherapy in Korean breast cancerpatients and the associations between RS and clinicopathologic characteristics. Materials and MethodsThe 21-gene assay was performed on 212 patients with estrogen receptor-positive earlybreast cancer in five institutions. Each center made systemic treatment decisions bothbefore and after the knowledge of assay results. ResultsAmong the 212 patients, 132 (62.3%) had a low RS of < 18, 60 (28.3%) had an intermediateRS of 18-30, and 20 (9.4%) had a high RS of ! 31. Histologic grade, presence ofmicrometastases, Ki-67, and presence of lymphatic invasion were statistically associatedwith the RS results. Treatment decisions were changed in 115 of 212 patients (54.2%) in109 of 212 (51.4%) from chemotherapy plus hormone therapy to hormone therapy, and insix of 212 (2.8%) from hormone therapy to chemotherapy plus hormone therapy. ConclusionThe 21-gene breast cancer assay proved to have a significant impact on treatment decision-making. The test reduces chemotherapy use in more than 50% of Korean estrogenreceptor-positive, early breast cancer patients.
Abstract
Purpose The 21-gene (Oncotype DX) recurrence score (RS) assay is useful in predicting the benefitsof adjuvant chemotherapy for early breast cancer patients and is widely used in Westerncountries. However, to date, it has not gained much popularity in East Asia. We analyzedthe results from five institutions’ experience from using the 21-gene assay and examinedthe impact of assay results on decision making of chemotherapy in Korean breast cancerpatients and the associations between RS and clinicopathologic characteristics. Materials and MethodsThe 21-gene assay was performed on 212 patients with estrogen receptor-positive earlybreast cancer in five institutions. Each center made systemic treatment decisions bothbefore and after the knowledge of assay results. ResultsAmong the 212 patients, 132 (62.3%) had a low RS of < 18, 60 (28.3%) had an intermediateRS of 18-30, and 20 (9.4%) had a high RS of ! 31. Histologic grade, presence ofmicrometastases, Ki-67, and presence of lymphatic invasion were statistically associatedwith the RS results. Treatment decisions were changed in 115 of 212 patients (54.2%) in109 of 212 (51.4%) from chemotherapy plus hormone therapy to hormone therapy, and insix of 212 (2.8%) from hormone therapy to chemotherapy plus hormone therapy. ConclusionThe 21-gene breast cancer assay proved to have a significant impact on treatment decision-making. The test reduces chemotherapy use in more than 50% of Korean estrogenreceptor-positive, early breast cancer patients.
참고문헌 (25)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival and Prevalence in 2010", Cancer Research and Treatment, 45(1), pp.1~14 (2013), 대한암학회[DOI]
- Paik S, "Gene expression and benefit of chemotherapy in women with nodenegative, estrogen receptor-positive breast cancer", J Clin Oncol, 24, pp.3726~3734 (2006)
- Paik S, "A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer", N Engl J Med, 351, pp.2817~2826 (2004)
- Harris L, "American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer", J Clin Oncol, 25, pp.5287~5312 (2007)
- "National Comprehensive Cancer Network Practice Guidelines in Oncology. Breast Cancer (version v3, 2013)" (2013)[URL]
- Aebi S, "Primary breastcancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up", Ann Oncol, 22(Suppl 6), pp.12~24 (2011)
- Goldhirsch A, "Strategies for subtypes: dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011", Ann Oncol, 22, pp.1736~1747 (2011)
- Lo SS, "Prospective multicenter study of the impact of the 21-gene recurrence score assay on medical oncologist and patient adjuvant breast cancer treatment selection", J Clin Oncol, 28, pp.1671~1676 (2010)
- Geffen DB, "The impact of the 21-gene recurrence score assay on decision making about adjuvant chemotherapy in early-stage estrogen-receptor-positive breast cancer in an oncology practice with a unified treatment policy", Ann Oncol, 22, pp.2381~2386 (2011)
- Albanell J, "Prospective transGEICAM study of the impact of the 21-gene Recurrence Score assay and traditional clinicopathological factors on adjuvant clinical decision making in women with estrogen receptor-positive(ER+)nodenegative breast cancer", Ann Oncol, 23, pp.625~631 (2012)
- Ademuyiwa FO, "The effects of oncotype DX recurrence scores on chemotherapy utilization in a multi-institutional breast cancer cohort", Breast Cancer Res Treat, 126, pp.797~802 (2011)
- Kamal AH, "Breast medical oncologists' use of standard prognostic factors to predict a 21-gene recurrence score", Oncologist, 16, pp.1359~1366 (2011)
- Asad J, "Does oncotype DX recurrence score affect the management of patients with early-stage breast cancer?", Am J Surg, 196, pp.527~529 (2008)
- Eiermann W, "The 21-gene recurrence score assay impacts adjuvant therapy recommendations for ER-positive, nodenegative and node-positive early breast cancer resulting in a risk-adapted change in chemotherapy use", Ann Oncol, 24, pp.618~624 (2013)
- Joh JE, "The effect of Oncotype DX recurrence score on treatment recommendations for patients with estrogen receptor-positive early stage breast cancer and correlation with estimation of recurrence risk by breast cancer specialists", Oncologist, 16, pp.1520~1526 (2011)
- Hornberger J, "Economic analysis of targeting chemotherapy using a 21-gene RT-PCR assay in lymph-node-negative, estrogen-receptor-positive, early-stage breast cancer", Am J Manag Care, 11, pp.313~324 (2005)
- de Boer RH, "The impact of a genomic assay(Oncotype DX)on adjuvant treatment recommendations in early breast cancer", Med J Aust, 199, pp.205~208 (2013)
- Biroschak JR, "Impact of Oncotype DX on treatment decisions in ER-positive, node-negative breast cancer with histologic correlation", Breast J, 19, pp.269~275 (2013)
- Tsoi DT, "Costeffectiveness analysis of recurrence score-guided treatment using a 21-gene assay in early breast cancer", Oncologist, 15, pp.457~465 (2010)
- Flanagan MB, "Histopathologic variables predict Oncotype DX recurrence score", Mod Pathol, 21, pp.1255~1261 (2008)
- Wolf I, "Association between standard clinical and pathologic characteristics and the 21-gene recurrence score in breast cancer patients : a population-based study", Cancer, 112, pp.731~736 (2008)
- Auerbach J, "Can features evaluated in the routine pathologic assessment of lymph node-negative estrogen receptor-positive stage I or II invasive breast cancer be used to predict the Oncotype DX recurrence score?", Arch Pathol Lab Med, 134, pp.1697~1701 (2010)
- Geradts J, "The oncotype DX recurrence score is correlated with a composite index including routinely reported pathobiologic features", Cancer Invest, 28, pp.969~977 (2010)
- Goldstein LJ, "Prognostic utility of the 21-gene assay in hormone receptor-positive operable breast cancer compared with classical clinicopathologic features", J Clin Oncol, 26, pp.4063~4071 (2008)
- Sparano JA, "TAILORx : trial assigning individualized options for treatment(Rx)", Clin Breast Cancer, 7, pp.347~350 (2006)
