Multi-gene assays: effect on chemotherapy use, toxicity and cost in estrogen receptor-positive early stage breast cancer-Reference-Cited by-同舟云学术

Multi-gene assays: effect on chemotherapy use, toxicity and cost in estrogen receptor-positive early stage breast cancer

Published:2019-04 Issue:5 Volume:8 Page:289-304
ISSN:2042-6305
Container-title:Journal of Comparative Effectiveness Research
language:en
Short-container-title:Journal of Comparative Effectiveness Research

Author:

Hochheiser Lou¹,Hornberger John²,Turner Michelle²,Lyman Gary H³

Affiliation:

1. Professor Emeritus, Department of Family Practice, University of Vermont, Burlington, VT 83001, USA

2. Genomic Health, Inc., Redwood City, CA 94063, USA

3. Fred Hutchinson Cancer Center & The University of Washington, Seattle, WA 98109, USA

Abstract

Aim: To assess multi-gene assay (MGA) effects on chemotherapy use, toxicities, recurrences, and costs in estrogen receptor-positive early breast cancer. Methods: Meta-analysis performed using data from public databases. Results: Studies included 12,202 women. Relative to no testing, chemotherapy use was higher with 12-gene and 70-gene and lower with PAM50 (commercial) and 21-gene MGAs. Overall, 1643 distant recurrences occurred with no testing, declining by 231 (21-gene), 121 (70-gene), 54 (12-gene) and 94 (PAM50); only the 21-gene assay resulted in no risk of increasing the number of distant recurrences. Relative to ‘no testing’, total cost of care declined only with 21-gene MGA. Conclusion: MGAs differ in chemotherapy use and related outcomes for women with estrogen receptor-positive early breast cancer.

Publisher

Future Medicine Ltd

Subject

Health Policy

Link

https://www.futuremedicine.com/doi/pdf/10.2217/cer-2018-0137

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