Response to real-life decision-making impact of oncotype DX

AUGUSTOVSKI F,; SOTO N,; CAPORALE J,; GONZALEZ L,; GIBBONS L,; CIAPPONI A.

BREAST CANCER RESEARCH AND TREATMENT

SPRINGER

Lugar: Berlin; Año: 2015

0167-6806

We were pleased to receive the feedback provided in theletter by Bertelli et al. about their additional clinicalexperience with the 21 gene essay -Oncotype DX. Asmentioned by the authors, the larger effect they found indecision impact in the highly selected population theydescribe is in line with our own findings. Additionally,even though we did not find this same trend in net reductionof chemotherapy, heterogeneity between studies washigh regarding this outcome, especially when analyzing thesparing chemotherapy effect in patients classified by thetest as belonging to the intermediate risk group. Theauthors provide details on previous experience where othermarkers were found to be highly correlated with patientsbeing classified as low or high risk, thus rendering the testnot necessary and likely leading to a higher proportion ofpatients belonging to the intermediate group, where evidenceregarding the effect of chemotherapy is less clear [1]and where local practice might be a factor of increasedrelevance. Further studies will probably refine these issues,and also help to better determine its cost-effectiveness,which has been favorably judged, as the author?s state, byNICE in the UK