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Oncotype DX for breast cancer

Indications: - quantifies the likelihood of disease recurrence in women with early-stage breast cancer - assesses likely benefit from certain types of chemotherapy - developed for women with early-stage invasive breast cancer who are estrogen receptor positive with negative lymph nodes - assessment of need for chemotherapy* in women with hormone receptor positive, axillary node negative breast cancer * in addition to hormonal therapy [3] Contraindications: - not appropriate for carcinoma in situ - not appropriate for metastatic cancer Procedure: - RT-PCR analysis of a panel of 21 genes obtained from biopsy - expression of 16 cancer-related genes [2] - Ki67, STK15, Survivin or BIRC5, CCNB1 or cyclin B1, MYBL2, GRB7, HER2, ER, PGR, BCL2, SCUBE2, MMP11 or stromelysin 3, CTSL2 or cathepsin L2, GSTM1, CD68, & BAG1 - 5 reference genes - ACTB (beta-actin), GAPDH, RPLPO, GUS, TFRC [2] - recurrence Score is a number between 0 & 100 that corresponds to a specific likelihood of breast cancer recurrence within 10 years of the initial diagnosis Specimen: - obtained fron tissue removed during the original surgery (lumpectomy, mastectomy, or core biopsy) - thin sections of the formalin-fixed, paraffin-embedded tissue are sent to Genomic Health Notes: - introduced in 2004 - price (2010) $4075

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breast cancer

General

Oncotype DX breast cancer 21 mRNA expression analysis

References

  1. Wikipedia: Oncotype DX http://en.wikipedia.org/wiki/Oncotype_DX
  2. Paik S, Tang G, Shak S et al Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006 Aug 10;24(23):3726-34 PMID: 16720680
  3. Sparano JA, Gray RJ, Makower DF et al Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer. N Engl J Med. June 3, 2018 PMID: 29860917 https://www.nejm.org/doi/full/10.1056/NEJMoa1804710 - ASCO News Release. June 3, 2018 Most Women With Early Stage Breast Cancer Can Forgo Chemotherapy When Guided by a Diagnostic Test. https://www.asco.org/about-asco/press-center/news-releases/most-women-early-stage-breast-cancer-can-forgo-chemotherapy
  4. Sparano JA, Gray RJ, Makower DF et al Prospective Validation of a 21-Gene Expression Assay in Breast Cancer. N Engl J Med. 2015 Nov 19;373(21):2005-14. Epub 2015 Sep 27. PMID: 26412349 Free PMC Article
  5. ARUP Consult: Breast Cancer Biomarkers The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/breast-cancer - ARUP Consult: Hereditary Breast and Ovarian Cancer https://arupconsult.com/ati/hereditary-breast-and-ovarian-cancer