Abstract
Introduction
Oncotype Dx (ODX) is a genetic assay that analyzes tumor recurrence risk and provides
chemotherapy recommendations for T1-T2 stage, hormone receptor-positive, human epidermal
growth factor receptor-negative, and nodal-negative breast cancer patients. Despite
its established validity, the utilization of this assay is suboptimal. The study aims
to evaluate factors that are associated with adherence rate with the testing guidelines
and examine changes in utilization trends.
Methods
This is a retrospective study, utilizing data from the National Cancer Database from
2010 to 2017. Patients who met the ODX testing guidelines were first evaluated for
testing adherence. Secondly, all patients who underwent ODX testing were assessed
to evaluate the trend in ODX utilization.
Results
A total of 429,648 patients met the criteria for ODX, and 43.4% of this population
underwent testing. Advanced age, racial minorities, low-income status, well-differentiated
tumor grade, uninsured status, and treatment at community cancer centers were associated
with a decreased likelihood of receiving ODX in eligible patients. Additionally, a
notable amount of testing was performed on patients who did not meet the ODX testing
criteria. Among the 295,326 patients that underwent ODX testing, 16.6% of patients
were node-positive and 1.8% had T3 or T4 stage tumors.
Conclusions
A considerable number of patients who were eligible for ODX did not receive it, indicating
potential barriers to care and disparities in breast cancer treatment. ODX usage has
been expanded to broader patient populations, indicating more research is needed to
validate the effectiveness of the assay in these patient groups.
Keywords
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Article info
Publication history
Published online: February 07, 2023
Accepted:
January 8,
2023
Received in revised form:
December 11,
2022
Received:
February 28,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
