The application of Oncotype DX in early-stage lymph-node-positive disease.
The recurrence score derived from the 21-gene Oncotype DX assay is both prognostic and predictive of adjuvant chemotherapy benefit in node-negative, estrogen-receptor-positive breast cancer patients treated with tamoxifen. This has led to a remarkable shift in the treatment paradigm, with a sizeable number of patients being able to avoid adjuvant chemotherapy. The recurrence score was then analyzed in a large retrospective study with node-positive, estrogen-receptor-positive patients, in which it demonstrated both prognostic and predictive abilities. This review introduces the clinical trials that validated the Oncotype DX assay in the node-negative population, highlights the studies evaluating the utility of the assay in node-positive patients, examines the impact of the assay results on treatment decisions, and discusses the health outcomes and health care expenditures associated with this assay.
Division of Hematology/Oncology, Department of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 676 N. St Clair, Suite 850, Chicago, IL, 60611, USA.
Sarika
S
Jain
William J
WJ
Gradishar
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D003657:Decision Making; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D011237:Predictive Value of Tests; D011379:Prognosis; D011960:Receptors, Estrogen / Q000235:genetics; D015203:Reproducibility of Results
D000970:Antineoplastic Agents; D011960:Receptors, Estrogen