The Ottawa Hospital Cancer Center, University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Duke Cancer Institute, Duke University, Durham, NC 27710, USA.
Curr Oncol. 2021 Feb 4;28(1):800-812. doi: 10.3390/curroncol28010077.
The literature suggests that medical oncologists differ on how they use the Oncotype DX (ODX) genomic assay for making decisions about systemic therapy in breast cancer patients. Given the emergence of data supporting the use of genomic profiling for the prognosis and predicting benefit of chemotherapy, we surveyed medical oncologists in Canada to assess their usage and perception of the ODX assay.
A 34-item survey was distributed to Canadian medical oncologists via the Canadian Association of Medical Oncologists. Data was collected on physician demographics, ODX usage patterns, and physicians' perception of the impact clinical and pathologic characteristics make on ODX utilization.
Response rate was 20.6% with 47 responses received from 228 survey sent. Forty-five responses were eligible for analysis. Sixty-two percent (28/45) of respondents treated predominantly breast cancer, and 60% (27/45) have been in practice for at least 10 years. The most cited reason for using ODX was to avoid giving patients unnecessary chemotherapy (64%; 29/45). Sixty-seven percent (30/45) deferred making treatment decisions until ODX testing was completed. Factors most strongly impacting ODX utilization included: patient request, medical comorbidities and tumor grade. In clinical scenarios, ODX was more frequently selected for patients aged 40-65 (vs. <40 or >65), grade 2 tumors (vs. grade 1 or 3), and Ki-67 index of 10-20% (vs. <10% or >20%).
This survey demonstrated that Canadian medical oncologists are preferentially using ODX to avoid giving patients unnecessary chemotherapy. The utilization of ODX is mainly in patients with intermediate clinical and pathologic features.
文献表明，医学肿瘤学家在使用 Oncotype DX（ODX）基因组检测来决定乳腺癌患者的系统治疗方案方面存在差异。鉴于支持使用基因组分析进行预后和预测化疗获益的数据的出现，我们调查了加拿大的医学肿瘤学家，以评估他们对 ODX 检测的使用和看法。
通过加拿大医学肿瘤学家协会向加拿大医学肿瘤学家分发了一份包含 34 个项目的调查。收集了医生的人口统计学数据、ODX 使用模式以及医生对临床和病理特征对 ODX 使用的影响的看法。
响应率为 20.6%，从 228 份调查中收到了 47 份回复。45 份回复符合分析条件。62%（28/45）的受访者主要治疗乳腺癌，60%（27/45）的医生至少有 10 年的从业经验。使用 ODX 的最常见原因是避免给患者不必要的化疗（64%；29/45）。67%（30/45）的医生在完成 ODX 检测后才做出治疗决策。对 ODX 使用影响最大的因素包括：患者要求、合并症和肿瘤分级。在临床情况下，ODX 更常被用于年龄在 40-65 岁的患者（<40 岁或>65 岁）、2 级肿瘤（1 级或 3 级）和 Ki-67 指数为 10-20%（<10%或>20%）的患者。
这项调查表明，加拿大医学肿瘤学家更倾向于使用 ODX 来避免给患者不必要的化疗。ODX 的使用主要针对具有中等临床和病理特征的患者。
