NICE Expands Oncotype DX Use for BreastCancerChemotherapy Decisions

NICE recommends expanded use of Oncotype DX Breast Recurrence Score test to guide chemotherapy decisions in postmenopausal women with early-stage HR positive, HER2 negative breast cancer. The test helps identify low-risk patients who can avoid chemotherapy, reducing unnecessary treatment and associated side effects.

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Bijay Laxmi
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NICE Expands Oncotype DX Use for BreastCancerChemotherapy Decisions

NICE Expands Oncotype DX Use for BreastCancerChemotherapy Decisions

The National Institute for Health and Care Excellence (NICE) in the UK has recommends, decisions, early, stage, cancer the expanded use of the Oncotype DX Breast Recurrence Score test to guide chemotherapy treatment decisions in postmenopausal women with early-stage hormone receptor (HR) positive, HER2 negative breast cancer involving up to 3 positive nodes. The recommendation, made on May 10, 2024, could spare many women from chemotherapy and its associated side effects.

Why this matters: This decision has significant implications for breast cancer treatment, as it enables more targeted and personalized care, reducing unnecessary chemotherapy and its associated side effects. By optimizing treatment decisions, this recommendation can improve patient outcomes and reduce healthcare costs.

The Oncotype DX test provides specific information about an individual's response to chemotherapy, enabling more targeted treatment decisions. It can also be used to guide chemotherapy decisions in male, trans, non-binary, and intersex patients, depending on their hormonal profile. The expanded use follows a prior NICE recommendation for the test's use in patients with early-stage HR positive, HER2 negative breast cancer without nodal involvement.

The recommendation is supported by data from a multicenter prospective study that included 68 women with early-stage HR positive, HER2 negative breast cancer with 1 to 3 positive lymph nodes. The study found that receipt of the recurrence score led to a 51.5% absolute reduction and a 64.5% relative reduction in chemotherapy. Caroline Archer, BSc, MBBS, MRCP, consultant medical oncologist at Portsmouth Hospital NHS Trust, described the decision as "a practice-changing moment for node-positive patients and the NHS. There is an urgent need to target chemotherapy more precisely to those most likely to benefit from it, so that patients can avoid unnecessary adverse effects."

Simon Holt, MD, professor of Health and Life Science at Swansea University and Peony Breast Care Unit at Prince Philip Hospital, added, "The use of the test will reduce the suffering and inconvenience by sparing up to 85% of people unnecessary chemotherapy, which in turn then reduces the care demands on oncology services. It also reduces significantly the cost of treatment, so that NHS resources can be redistributed to other medical priorities." The recommendation is expected to benefit postmenopausal patients and the NHS by reducing unnecessary chemotherapy and its associated side effects, while also reducing healthcare costs.

The Oncotype DX Breast Recurrence Score test is a tumor profiling test that helps identify women who are at low risk of their breast cancer returning and can therefore avoid chemotherapy. The expanded use of this test in England represents a significant step forward in the targeted treatment of breast cancer, enabling doctors to make more personalized treatment decisions based on an individual patient's tumor profile. As research continues to advance our understanding of breast cancer biology and treatment response, tools like the Oncotype DX test will play an increasingly important role in optimizing care and outcomes for patients.