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Impact of O nco type DX testing on adjuvant treatment decisions in patients with early breast cancer: A single‐center study in the U nited A rab E mirates
Author(s) -
Jaafar Hassan,
Bashir Mohamed Al,
Taher Ali,
Qawasmeh Khaled,
Jaloudi Mohammed
Publication year - 2014
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12259
Subject(s) - medicine , mcnemar's test , breast cancer , confidence interval , exact test , adjuvant therapy , oncology , cancer , cohort , statistics , mathematics
Aim To evaluate the distribution of the O nco type DX R ecurrence S core (a validated prognostic/predictive tool in early‐stage estrogen‐receptor positive [ ER +] breast cancer) and its impact on adjuvant treatment decisions in the U nited A rab E mirates. Methods A retrospective analysis of a single‐center cohort. Results The analysis included 47 node‐negative ER + breast cancer patients with low‐to‐intermediate risk according to the S t. G allen criteria. The mean ( SD ) R ecurrence S core result was 17.7 (8.0); 25 (53.2%), 19 (40.4%) and 3 (6.4%) patients had low, intermediate and high R ecurrence S core results, respectively. R ecurrence S core risk categories were concordant with risk groups according to the S t. G allen criteria in 23 patients (48.9%). Before testing, 24 patients (51.1%) were recommended endocrine therapy alone and 23 patients (48.9%) were recommended chemoendocrine therapy. After testing, 13 patients (27.7%; 95% confidence interval 16.3–42.4%) had a treatment change (from pretesting recommendation to posttesting actual treatment), and chemotherapy use decreased overall (from 48.9 to 25.5%; P = 0.0023, M c N emar's test), and particularly in the low R ecurrence S core category (from 56.0 to 8.0%; P = 0.0005, M c N emar's test). After testing, the proportions of patients with chemoendocrine therapy recommendations differed significantly across the R ecurrence S core categories (8.0, 36.8 and 100% in the low, intermediate and high R ecurrence S core categories, respectively; P = 0.0012, F isher's exact test). With an average follow‐up of 31.2 months (range: 17–51), no locoregional/systemic relapses were observed. Conclusion This first decision impact study in a M iddle E astern country showed the significant effect of O nco type DX testing on clinical practice, further demonstrating the consistent impact of such testing worldwide.