The Oncotype DX® test as standard of care to guide chemotherapy treatment decisions
Only the Oncotype DX Breast Recurrence Score test is incorporated in the four major international guidelines and recommended by two major European health technology assessment (HTA) bodies.
Due to the comprehensive dataset of the Oncotype DX Breast Recurence Score test, guidelines and HTA body recommendations position the Oncotype DX test as the preferred multigene assay1-8.
The majority of recommendations have been updated after the publication of the two major clinical trials TAILORx and RxPONDER.
The most recent update is of the St Gallen guidelines. The 2023 update states it is commonplace to use genomic assays to determine whether HR+, HER2- early-stage breast cancer patients require adjuvant chemotherapy in addition to adjuvant endocrine therapy. It acknowledges that the practice-changing trials TAILORx and RxPONDER have shown that adding chemotherapy to endocrine therapy does not improve outcomes in postmenopausal patients whose tumours have low Recurrence Score® results. The update also highlights the need to test premenopausal patients as not all require chemotherapy4.
Below is a high-level overview of each of the major guidelines and HTA bodies worldwide.
a National Comprehensive Cancer Network® (NCCN®) are registered trademarks of NCCN. ASCO and ESMO are trademarks of the American Society of Clinical Oncology and European Society for Medical Oncology, respectively. NCCN, National Institute for Health and Care Excellence (NICE), St Gallen International Consensus Panel, ASCO and ESMO do not endorse any product or therapy.
b National Institute for Health and Care Excellence (NICE) Diagnostics Guidance DG34, December 2018. www.nice.org.uk/guidance/dg34 (6 Feb 2020). All rights reserved. Subject to Notice of rights NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.
c As voted by a clear majority of the St Gallen International Expert Consensus panel
Inclusion in Major Guidelines and Health Technology Assessment bodies
Oncotype DX® | MammaPrint® | EndoPredict® | Prosigna® | |
---|---|---|---|---|
NCCN Category: Preferred 1 |
✓ | |||
ASCO 2 | ✓ Strongly recommended for all NO and postmenopausal N1 patients |
✓ Strongly recommended for high-clinical risk, and postmenopausal N0 and N1 patients |
✓ Moderately recommended for postmenopausal N0 and N1 patients |
✓ Moderately recommended for postmenopausal N0 patients |
St. Gallen 3,4 | ✓ | ✓ | ||
ESMO 5 | ✓ | ✓ | ✓ | ✓ |
NICE Diagnostics Guidance (UK) 6 | ✓ | ✓ | ✓ | |
IQWiG (Germany) 7 | ✓ |
In summary, the guideline recommendations and the clinical validation make the Oncotype DX® test the preferred choice for your HR+, HER2-, early-stage breast cancer patients. Learn more about the evidence behind the Oncotype DX test in node-negative and node-positive patients:
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References