title: [Economic assessment of the routine use of Oncotype DX® assay for early breast cancer in Franche-Comte region].
abstract: Oncotype DX® has been validated as quantifying the likelihood of distant recurrence at 10 years and overall chemotherapy benefit in patients with estrogen-receptor-positive and HER-2-negative early breast cancer. In 2012, this genomic signature was routinely available for patients in Franche-Comté, France. Patients eligible for Oncotype DX(®) testing had a ER-positive, HER-2-négative early breast cancer with a nodal involvement limited to 0 or 1 positive-node without extracapsular spread; an adjuvant chemotherapy was indicated based on usual prognostic factors. The aim was to assess the economic impact of Oncotype DX(®) testing in a French region. A cost-minimisation analysis from the French Public Healthcare System perspective was performed. The availability of Oncotype DX(®) in Franche-Comté, France, and its use in clinical routine allowed a decrease of 73 % of adjuvant chemotherapy without increase of the cost of the patients' management and with a potential reduction of the cost for the French Public Healthcare System. This strategy was successful and may allow the reimbursement of this test in France for patients with early breast cancer.
authors.affiliation: CHU de Besançon, pôle pharmacie, Besançon, France, Inserm U645 EA-2284 IFR-133, Université de Franche-Comté, 25000 Besançon, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Nerich
authors.affiliation: Inserm U645 EA-2284 IFR-133, Université de Franche-Comté, 25000 Besançon, France, CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Elsa
authors.initials: E
authors.lastname: Curtit
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bazan
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Montcuquet
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Cristian
authors.initials: C
authors.lastname: Villanueva
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Chaigneau
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Cals
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Méneveau
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Erion
authors.initials: E
authors.lastname: Dobi
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Hamadi
authors.initials: H
authors.lastname: Altmotlak
authors.affiliation: CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Algros
authors.affiliation: Agence Régionale de Santé, Franche-Comté, Besançon, France.
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Choulot
authors.affiliation: Réseau Oncolie, Besançon, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Nallet
authors.affiliation: CHU de Besançon, pôle pharmacie, Besançon, France, Inserm U645 EA-2284 IFR-133, Université de Franche-Comté, 25000 Besançon, France.
authors.forename: Samuel
authors.initials: S
authors.lastname: Limat
authors.affiliation: Agence Régionale de Santé, Franche-Comté, Besançon, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Mansion
authors.affiliation: Inserm U645 EA-2284 IFR-133, Université de Franche-Comté, 25000 Besançon, France, CHU de Besançon, Oncologie médicale, Hôpital Jean Minjoz, boulevard Fleming 25030 Besançon cedex, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pivot
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000008:administration & dosage; D003657:Decision Making; D000077143:Docetaxel; D005260:Female; D005602:France; D020869:Gene Expression Profiling / Q000191:economics / Q000379:methods; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D011960:Receptors, Estrogen / Q000032:analysis*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000191:economics* / Q000379:methods; D012680:Sensitivity and Specificity; D043823:Taxoids / Q000008:administration & dosage; D047368:Tumor Burden
chemical_list: D003520:Cyclophosphamide; D000077143:Docetaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D043823:Taxoids
keywords: Oncotype DX®; adjuvant chemotherapy; breast cancer; cost-minimisation analysis; genomic signature