Chen Shuyi, Thacker Christopher, Wang Shengxuan, Young Katelyn A, Hoffman Rebecca L, Blansfield Joseph A
Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania.
Geisinger Surgery Institute, Danville, Pennsylvania.
J Surg Res. 2023 Jun;286:65-73. doi: 10.1016/j.jss.2023.01.002. Epub 2023 Feb 7.
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.
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.
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.
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.
Oncotype Dx（ODX）是一种基因检测方法，用于分析肿瘤复发风险，并为T1-T2期、激素受体阳性、人表皮生长因子受体阴性且无淋巴结转移的乳腺癌患者提供化疗建议。尽管该检测方法的有效性已得到确立，但其利用率仍不理想。本研究旨在评估与检测指南依从率相关的因素，并研究利用率趋势的变化。
这是一项回顾性研究，利用了2010年至2017年国家癌症数据库的数据。首先对符合ODX检测指南的患者进行检测依从性评估。其次，对所有接受ODX检测的患者进行评估，以评估ODX的使用趋势。
共有429,648名患者符合ODX标准，其中43.4%的患者接受了检测。高龄、少数族裔、低收入状态、肿瘤分化良好、未参保状态以及在社区癌症中心接受治疗与符合条件的患者接受ODX检测的可能性降低相关。此外，对不符合ODX检测标准的患者进行了大量检测。在接受ODX检测的295,326名患者中，16.6%的患者有淋巴结转移，1.8%的患者患有T3或T4期肿瘤。
相当数量符合ODX检测条件的患者未接受检测，这表明在乳腺癌治疗中存在潜在的护理障碍和差异。ODX的使用已扩展到更广泛的患者群体，这表明需要更多研究来验证该检测方法在这些患者群体中的有效性。
