lunes, 21 de mayo de 2012

Adoption of Gene Expression Profile Testing and... [J Clin Oncol. 2012] - PubMed - NCBI

Adoption of Gene Expression Profile Testing and... [J Clin Oncol. 2012] - PubMed - NCBI

J Clin Oncol. 2012 May 14. [Epub ahead of print]

Adoption of Gene Expression Profile Testing and Association With Use of Chemotherapy Among Women With Breast Cancer.


Michael J. Hassett, Melissa E. Hughes, and Jane C. Weeks, Dana-Farber Cancer Institute, Boston, MA; Samuel M. Silver, University of Michigan Cancer Center, Ann Arbor; James G. Herman, Sparrow Regional Cancer Center, Lansing; Jane E. Pettinga, Spectrum Health, Grand Rapids; David Share, BlueCross BlueShield of Michigan, Detroit, MI; Douglas W. Blayney, Stanford Cancer Center, Stanford; Joyce C. Niland, City of Hope National Medical Center, Duarte, CA; Stephen B. Edge, Roswell Park Cancer Institute, Buffalo; Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; P. Kelly Marcom, Duke Comprehensive Cancer Center, Durham, NC; Richard Theriault, MD Anderson Cancer Center, Houston, TX; Yu-Ning Wong, Fox Chase Cancer Center, Philadelphia; and Jonathan L. Vandergrift, National Comprehensive Cancer Network, Fort Washington, PA.


PURPOSEGene expression profile (GEP) testing is a relatively new technology that offers the potential of personalized medicine to patients, yet little is known about its adoption into routine practice. One of the first commercially available GEP tests, a 21-gene profile, was developed to estimate the benefit of adjuvant chemotherapy for hormone receptor-positive breast cancer (HR-positive BC). PATIENTS AND METHODSBy using a prospective registry data set outlining the routine care provided to women diagnosed from 2006 to 2008 with HR-positive BC at 17 comprehensive and community-based cancer centers, we assessed GEP test adoption and the association between testing and chemotherapy use.ResultsOf 7,375 women, 20.4% had GEP testing and 50.2% received chemotherapy. Over time, testing increased (14.7% in 2006 to 27.5% in 2008; P < .01) and use of chemotherapy decreased (53.9% in 2006 to 47.0% in 2008; P < .01). Characteristics independently associated with lower odds of testing included African American versus white race (odds ratio [OR], 0.70; 95% CI, 0.54 to 0.92) and high school or less versus more than high school education (OR, 0.63; 95% CI, 0.52 to 0.76). Overall, testing was associated with lower odds of chemotherapy use (OR, 0.70; 95% CI, 0.62 to 0.80). Stratified analyses demonstrated that for small, node-negative cancers, testing was associated with higher odds of chemotherapy use (OR, 11.13; 95% CI, 5.39 to 22.99), whereas for node-positive and large node-negative cancers, testing was associated with lower odds of chemotherapy use (OR, 0.11; 95% CI, 0.07 to 0.17). CONCLUSIONThere has been a progressive increase in use of this GEP test and an associated shift in the characteristics of and overall reduction in the proportion of women with HR-positive BC receiving adjuvant chemotherapy.
[PubMed - as supplied by publisher]

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