Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Display session 2

1156 - The concordance of treatment decision guided by Oncotype and the PREDICT tool in early stage breast cancer

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Breast Cancer

Presenters

Hadar Goldvaser

Citation

Annals of Oncology (2019) 30 (suppl_5): v55-v98. 10.1093/annonc/mdz240

Authors

H. Goldvaser1, R. Yerushalmi2, T. Shochat3, M. Sarfaty1, D. Goldstein1, C. Mayer1

Author affiliations

  • 1 Davidoff Cencer Center, Rabin Medical Center, 49100 - Peth Tikva/IL
  • 2 Davidoff Cencer Center, Rabin Medical Center Davidoff Cancer Centre, Beilinson Campus, 49100 - Petah Tikva/IL
  • 3 Statistical Consulting Unit, Rabin Medical Center, 49100 - Peth Tikva/IL
More

Resources

Abstract 1156

Background

Decision on adjuvant chemotherapy for early breast cancer can be guided by genomic assays. PREDICT is a validated free online tool that estimates the benefit from adjuvant chemotherapy using clinical and pathological data. The concordance of expected clinical decisions guided by Oncotype analysis and the PREDICT in unknown.

Methods

A retrospective single center cohort study comprising all women with estrogen receptor (ER) positive, human epidermal growth factor receptor 2 negative, node negative disease, whose tumors were sent for OncotypeDX analysis. Estimation of 10-year overall survival (OS) benefit from 2nd generation chemotherapy was calculated using the PREDICT 2.1v tool. Omission of chemotherapy was expected to be advised when Oncotype recurrence score (RS) was ≤25 or when the estimated 10-year OS benefit by the PREDICT was <2%. The tests were considered concordant for women with RS ≤ 25 and estimated PREDICT benefit<2% or for women with RS > 25 and estimated PREDICT benefit ≥2%. Concordance was presented using percentages and the K coefficient. The impact on concordance of pre-specified histological features was assessed, including tumor size, intensity of ER and progesterone receptor (PR), grade, Ki67 and perineural and lymphovascular invasion. The difference between the subgroups was calculated using Chi-squared test.

Results

A total of 445 women were included. Overall concordance was 75% (K = 0.284), with 55 (12.5%) women with low RS but estimated PREDICT benefit ≥2% and 55 (12.5%) with high RS and estimated PREDICT benefit<2%. The concordance was significantly higher for grade 1 disease compared to grade 2-3 (93% vs 72%, p < 0.001), tumor ≤1cm compared to > 1cm (85% vs 72%, p = 0.009), PR positive compared to PR negative (78% vs 58%, p < 0.001) and ki67<20% compared to ≥ 20% (82% vs 54%, p < 0.001). The intensity of ER and the presence of perineural or lymphovascular invasion had no significant impact on concordance.

Conclusions

Compared to PREDICT, using Oncotype in node negative, ER positive disease is expected to change clinical decision in a quarter of patients. The concordance is influenced by pathological features. The use of Oncotype may not be necessary for clinically very low risk patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

H. Goldvaser: Honoraria (self): Roche. R. Yerushalmi: Honoraria (self): Roche; Honoraria (self): Medison; Honoraria (self): AstraZeneca; Honoraria (self): Novartis; Honoraria (self): Teva. M. Sarfaty: Honoraria (self): Roche; Honoraria (self): MSD; Honoraria (self): Medison; Honoraria (self): Novartis. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.