The impact of the Oncotype Dx breast cancer assay in clinical practice: a systematic review and meta-analysis

Breast Cancer Research and Treatment
Josh J Carlson, Joshua A Roth

Abstract

The impact of the Oncotype Dx (ODX) breast cancer assay on adjuvant chemotherapy (ACT) treatment decisions has been evaluated in many previous studies. However, it can be difficult to interpret the collective findings, which were conducted in diverse settings with limited sample sizes. We conducted a systematic review and meta-analysis to synthesize the results and provide insights about ODX utility. Studies, identified from PubMed, Embase, ASCO, and SABCS, were included if patients had ER+, node -, early-stage breast cancer, reported use of ODX to inform actual ACT decisions. Information was summarized and pooled according to: (1) distribution of ODX recurrence scores (RS), (2) impact of ODX on ACT recommendations, (3) impact of ODX on ACT use, and (4) proportion of patients following the treatment suggested by the ODX RS. A total of 23 studies met inclusion criteria. The distribution of RS categories was 48.8 % low, 39.0 % intermediate, and 12.2 % high (21 studies, 4,156 patients). ODX changed the clinical-pathological ACT recommendation in 33.4 % of patients (8 studies, 1,437 patients). In patients receiving ODX, receipt of ACT were: 28.2 % overall, 5.8 % low, 37.4 % intermediate, and 83.4 % high. Low RS patients were signif...Continue Reading

References

Aug 1, 1994·American Journal of Epidemiology·S Greenland
Sep 24, 1999·JAMA : the Journal of the American Medical Association·P JüniM Egger
Dec 14, 2004·The New England Journal of Medicine·Soonmyung PaikNorman Wolmark
Jul 19, 2005·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Nina OestreicherDavid L Veenstra
May 25, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Soonmyung PaikNorman Wolmark
Sep 7, 2006·Journal of the National Cancer Institute·Marc BuyseTRANSBIG Consortium
Oct 24, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lyndsay HarrisAmerican Society of Clinical Oncology
Feb 7, 2008·Annals of Internal Medicine·Luigi MarchionniSteven N Goodman
Feb 9, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Joseph A Sparano, Soonmyung Paik
Mar 4, 2008·Breast Cancer Research and Treatment·Marleen KokEls M J J Berns
Sep 24, 2008·American Journal of Surgery·Juhi AsadPaul I Tartter
Jan 7, 2009·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group
Feb 11, 2009·Journal of Surgical Oncology·Leonard R HenryPeter W Soballe
Jun 23, 2009·Molecular Diagnosis & Therapy·Lara Dunn, Angela Demichele
Jul 23, 2009·BMJ : British Medical Journal·David MoherPRISMA Group
Jul 28, 2009·Journal of Clinical Epidemiology·David MoherPRISMA Group
Nov 17, 2009·The Breast : Official Journal of the European Society of Mastology·K AlbainLaura van't Veer
Jan 13, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Eleftherios P MamounasNorman Wolmark
Jan 13, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Shelly S LoK Albain
Apr 8, 2010·International Journal of Injury Control and Safety Promotion·A Monique Clinton-SherrodRebecca T Leeb
Apr 24, 2010·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Shmuel H KlangJohn Hornberger
Jul 29, 2010·Cancer Control : Journal of the Moffitt Cancer Center·Kiran TuragaChristine Laronga
Oct 27, 2010·Nature Reviews. Clinical Oncology·Catherine OakmanAngelo Di Leo
Jan 5, 2011·Breast Cancer Research and Treatment·Foluso O AdemuyiwaSunil Badve
Sep 3, 2011·Journal of Oncology Practice·John HornbergerLouis Hochheiser
Nov 10, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Richard G GrayDavid J Kerr
Aug 8, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jennifer J GriggsSteven J Katz
Mar 7, 2013·The Breast : Official Journal of the European Society of Mastology·Grazia ArpinoLuigi Dogliotti
Jan 24, 2014·International Journal of Breast Cancer·Amber A GuthNina A Bickell

Citations

Dec 6, 2014·Expert Review of Molecular Diagnostics·Amalia M IssaGary E Marchant
Mar 24, 2015·Expert Review of Pharmacoeconomics & Outcomes Research·Miguel Angel SeguíAlfredo Gracia
Sep 16, 2014·Clinica Chimica Acta; International Journal of Clinical Chemistry·Larry J KrickaPaolo Fortina
Sep 6, 2015·Annals of Surgical Oncology·Maria KarstenTari A King
Feb 24, 2015·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Yasuto Naoi, Shinzaburo Noguchi
Jul 2, 2014·Scientific Reports·Joseph FennerGary D Luker
Apr 16, 2015·Journal of Comparative Effectiveness Research·Michelle KipLotte Steuten
Aug 15, 2015·The Breast Journal·Niamh ConlonLee K Tan
Jul 23, 2014·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Laura ZanottiMaria Rosa Cappelletti
May 2, 2015·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Bradley M TurnerDavid G Hicks
Jun 30, 2015·Bulletin du cancer·Camille FranchetMagali Lacroix-Triki
May 15, 2015·Irish Journal of Medical Science·E M QuinnMartin J O'Sullivan
Apr 22, 2016·Cancer Causes & Control : CCC·Rosemary D CressKenneth W Kizer
Apr 15, 2014·Critical Reviews in Oncology/hematology·Fabio PuglisiLucia Del Mastro
Apr 11, 2015·Breast Cancer Research and Treatment·Lindsey EnewoldLinda C Harlan
Sep 23, 2014·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Terri Patricia McVeighMichael J Kerin
Jul 18, 2014·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Adam C DiehlJoann N Bodurtha
Dec 21, 2014·Breast Cancer Research and Treatment·Jan J JobsenHenk Struikmans
Aug 11, 2016·Breast Cancer Research and Treatment·Benjamin M ParsonsLeah L Dietrich
Aug 22, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Joan AlbanellWolfgang Eiermann
Sep 19, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·C MarkopoulosR Masetti
Aug 9, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Wayne XuShantanu Banerji
Oct 22, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Katarzyna J Jerzak, Kathleen I Pritchard
Oct 25, 2016·Cancer Medicine·Jun-Long SongSheng-Rong Sun
Jan 26, 2016·Applied Immunohistochemistry & Molecular Morphology : AIMM·Thaer KhouryMateusz Opyrchal
Nov 11, 2016·Archives of Gynecology and Obstetrics·Catharina BartmannJoachim Diessner
Feb 2, 2017·Cancer Medicine·Luisel J Ricks-Santi, John Tyson McDonald
Nov 25, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Mark N LevineKathleen I Pritchard
Mar 24, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jagar JasemPeter Kabos
Jan 18, 2018·Cancer·Katherine E Reeder-HayesAnne-Marie Meyer
Mar 10, 2018·Annals of Surgical Oncology·Gulisa TurashviliHannah Y Wen
Mar 13, 2018·Archives of Pathology & Laboratory Medicine·Scott KizyJane Yuet Ching Hui
Apr 18, 2019·JCO Clinical Cancer Informatics·Manuela SalvucciJochen H M Prehn
Oct 24, 2018·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Vian ChengKimberly Schaff
Oct 17, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Mylin A Torres
Dec 2, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Nicole MittmannMark N Levine
Apr 18, 2015·Clinical Chemistry·Michael J DuffyPatrick M M Bossuyt
May 28, 2020·The Breast Journal·Gulisa Turashvili, Hannah Y Wen
May 20, 2020·Carcinogenesis·Jyotsana SinghalSharad S Singhal
Oct 17, 2018·Annals of the Royal College of Surgeons of England·N GreenC Fowler
Sep 12, 2019·Scientific Reports·Mehmet Eren AhsenSupinda Bunyavanich
Jan 9, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Young ChandlerJeanne S Mandelblatt
Jul 14, 2017·Breast Cancer Research and Treatment·Gulisa TurashviliHannah Y Wen
Apr 2, 2020·Breast Cancer Research and Treatment·Jan J JobsenEster Siemerink
Jun 4, 2017·Breast Cancer Research and Treatment·Gulisa TurashviliHannah Y Wen
Dec 14, 2017·Archives of Gynecology and Obstetrics·Michelle G RathJoachim Rom
Oct 23, 2018·Molecular and Clinical Oncology·Kelsey E LarsonStephen R Grobmyer
Oct 12, 2018·Indian Journal of Pathology & Microbiology·Harshima Disvini WijesingheMenaka Dilani S Lokuhetty
Mar 15, 2020·Breast Cancer Research and Treatment·Valerie E CrolleyJudy King
May 22, 2020·Breast Cancer Research and Treatment·K AlmstedtM Schmidt
Aug 17, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Anne KuijerThijs van Dalen

Related Concepts

Antineoplastic Chemotherapy Protocols
Mammary Neoplasms, Human
Combined Modality Therapy
Estrogen Effect
Neoplasm Metastasis
Neoplasm Proteins
Neoplasm Recurrence, Local
TNM Staging System
Neoplasms, Hormone-Dependent
Estrogen Nuclear Receptor

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