Trend and survival benefit of Oncotype DX use among female hormone receptor-positive breast cancer patients in 17 SEER registries, 2004–2015

Details

• Alternative Title:
  Breast Cancer Res Treat
• Personal Author:
  Zhang, Lu ; Hsieh, Mei-Chin ; Petkov, Valentina ; Yu, Qingzhao ; Chiu, Yu-wen ; Wu, Xiao-Cheng
• Description:
  Purpose
  
  To examine (1) the trend and associated factors of Oncotype DX (ODX) use among hormone receptor-positive (HR+) breast cancer (BC) patients in 2004–2015; (2) the trend of reported chemotherapy by Recurrence Score (RS); and (3) the survival differences associated with ODX use.
  
  Methods
  
  ODX data from Genomic Health Inc. were linked with 17 SEER registries data. HR + BC cases with lymph node negative (N0) or 1–3 positive LNs (N1) from 2004–2015 were analyzed. The Cochrane-Armitage trend test, logistic regression, Kaplan–Meier survival curve, and stratified Cox model were performed. Survival analysis was restricted to HR+/HER2− patients from 2010 to 2014, matched on propensity score.
  
  Results
  
  ODX use increased substantially from 2004 to 2015 (N0: 2.0% to 42.7%; N1: 0.3% to 27.9%). Non-Hispanic black and Medicaid insured patients had lower odds of receiving ODX. N0 patients with moderately differentiated or 2.1–5.0 cm tumor and N1 patients with well-differentiated or < 2.0 cm tumor had higher odds of using ODX. The reported chemotherapy use decreased significantly with low and intermediate RS, and increased for high RS among N0 patients. ODX use was associated with better breast cancer-specific survival [hazard ratio (95% CI) N0 1.96 (1.60–2.41), N1 1.90 (1.42–2.54)] and overall survival [N0 2.06 (1.83–2.31), N1 1.72 (1.42–2.09)], especially in the first 36 months.
  
  Conclusion
  
  ODX use has increased significantly since 2004, nonetheless disparities remain, especially for racial/ethnic minorities and Medicaid insured patients. Administering chemotherapy based on ODX results has been improved among N0 patients. Patients receiving ODX had better survival than those not.
  
  
• Subjects:
  Aged Aged, 80 And Over Biomarkers, Tumor Black Or African American Breast Neoplasms Female Gene Expression Profiling Humans Lymphatic Metastasis Middle Aged Neoplasm Grading Neoplasm Recurrence, Local Neoplasm Staging Nomograms SEER Program Survival Rate White

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• Source:
  Breast Cancer Res Treat. 180(2):491-501
• Pubmed ID:
  32060781
• Pubmed Central ID:
  PMC8715716
• Document Type:
  Journal Article
• Funding:
  R15 MD012387/MD/NIMHD NIH HHSUnited States/ ; R15MD012387/MD/NIMHD NIH HHSUnited States/ ; U58 DP003915/DP/NCCDPHP CDC HHSUnited States/ ; Internal funding/Clemson University/ ; HHSN261201300016I/CA/NCI NIH HHSUnited States/ ; U58DP003915/CC/CDC HHSUnited States/ ; HHSN261201300016C/CA/NCI NIH HHSUnited States/
• Volume:
  180
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:cf46073c3da616a0f89adb7299b20515ff5f5adbd653e2da6624f2f137d5d2dc
• Download URL:
  https://stacks.cdc.gov/view/cdc/113013/cdc_113013_DS1.pdf
• File Type:
  [PDF - 1.01 MB ]