Real-world analysis of clinical and economic impact of 21-gene recurrence score (RS) testing in early-stage breast cancer (ESBC) in Ireland.

Autor: McSorley LM; Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland. Lyndamcsorley1@gmail.com., Tharmabala M; Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland., Al Rahbi F; Department of Pathology, St. Vincent's University Hospital, Dublin, Ireland., McSorley K; Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland., Chew S; Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland., Evoy D; Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland., Geraghty JG; Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland., Prichard RS; Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland., Rothwell J; Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland., McCartan DP; Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland., McDermott EW; Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland., Keane M; Department of Medical Oncology, Galway University Hospitals, Galway, Ireland., Kennedy MJ; Department of Medical Oncology, St James's Hospital, Dublin, Ireland., O'Reilly S; Department of Medical Oncology, Cork University Hospital, Cork, Ireland., Millen SJ; Exact Sciences UK Ltd, London, UK., Crown JP; Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland., Smyth LM; Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland.; Loxo Oncology Inc., Stamford, CT, USA., Kelly CM; Department of Medical Oncology, The Mater Misericordiae University Hospital, Dublin, Ireland., Quinn CM; Department of Pathology, St. Vincent's University Hospital, Dublin, Ireland.; University College Dublin, Dublin, Ireland., Walshe JM; Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland.; University College Dublin, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2021 Aug; Vol. 188 (3), pp. 789-798. Date of Electronic Publication: 2021 Apr 09.
DOI: 10.1007/s10549-021-06211-w
Abstrakt: Purpose: Results from TAILOR-X suggest that up to 70% of hormone receptor-positive (HR+) node-negative (N0) ESBC patients (pts) may avoid chemotherapy (CT) with RS ≤ 25. We assess clinical and economic impacts of RS testing on treatment using real-world data.
Methods: From October 2011 to February 2019, a retrospective, cross-sectional observational study was conducted of HR+ N0 ESBC pts who had RS testing in Ireland. Pts were classified low risk (RS ≤ 25) and high risk (RS > 25). Clinical risk was calculated. Data were collected via electronic patient records. Cost data were supplied by the National Healthcare Pricing Regulatory Authority.
Results: 963 pts. Mean age is 56 years. Mean tumour size is 1.7 cm. 114 (11.8%), 635 (66%), 211 (22%), 3 (0.2%) pts had G1, G2, G3 and unknown G, respectively. 796 pts (82.8%) low RS, 159 (16.5%) high RS and 8 pts (0.7%) unknown RS. 263 pts (26%) were aged ≤ 50 at diagnosis; 117 (45%) had RS 0-15, 63 (24.5%) 16-20, 39 (15.3%) 21-25 and 40 (15.2%) RS 26-100. 4 pts (1.5%) had unknown RS. Post-RS testing, 602 pts (62.5%) had a change in CT decision; 593 changed to hormone therapy (HT) alone. In total, 262 pts received CT. Of pts receiving CT; 138 (53%) had RS > 25, 124 (47%) had RS ≤ 25. Of pts aged ≤ 50, 153 (58%) had high clinical risk, of whom 28 had RS 16-20. Assay use achieved a 62.5% change in treatment with 73% of pts avoiding CT. This resulted in savings of €4 million in treatment costs. Deducting assay costs, savings of €1.9 million were achieved.
Conclusion: Over the 8 years of the study, a 62.5% reduction in CT use was achieved with savings of over €1,900,000.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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