THE RETROSPECTIVE ANALYSIS OF GENE SPECIFIC ONCOTYPE DX ASSAY IN
PATIENTS WITH BREAST CANCER (TURKISH CASES)
Göker E1, Görümlü G1, Batıgün O2
1 University of Ege – Department of Oncology, 2 TEVA Turkey
RESULTS: The Turkish patients who took Oncotype DX assay
RATIONALE: Breast cancer is the second most prevalent type When we segment the data into subgroups; we see that minority of the presented a milder profile compared to the ones in United States. 60%
following lung cancer in females. 1 Out every 8 women is vulnerable to patients are in premenapousal period (17% - under 40 years of age), Of Turkish subjects were in low risk group where only 19% were found
breast cancer during lifetime. One of the major challenges in such a the majority of them are between 40 – 50 years of age (55% - n=16) to be high risk patients. Compared to the data of 85.000 women in
highly seen disease is the determination of initial risk factors and and the remaining are over 50 (28% n=13). The risk scores of United States, the results will possibly approach to each other as the
prediction of chemotherapy benefit. Oncotype DX is a gene/patient premenapousal women present a different profile than other age groups number of Turkish assays increase (52% of women in US are
specific assay that is recommended by ASCO (American Society of where high risk and low risk patients are equivalent (n=3 in both arms). considered as low risk where 13% are classified as high risk). Patients
Clinical Oncology) and NCCN (National Comprehensive Cancer Taking into account that the total population in this group is 8, we need in peri and post-menapousal period are likely to have similar results
Network) guidelines. more subjects to reach an analytic conclusion. 55% of our study group while pre-menapousal women differ. However, it is obvious that the data
consists of perimenapousal patients (n=26) where only 15% has high will change with the increasing number of patients.
recurrens scores. In other words 15% the women would anticipate
therapeutic benefit from chemotherapy while 62% (n=16) may try Patients Under 40 n=8
United States Turkey hormonal treatment alternative.
31≤
13%
19%
40%
Ages Between 40 - 50 n=26
18>
18 - 30
30%
18> 31≤
52% 21%
18 - 30 60% 80% 20%
35%
60% 10%
40%
0%
18> 18 - 30 31≤
20%
0%
18> 18 - 30 31≤ Risk Score Under 40 (n=8)
Risk Score All Patients (n=47)
18> 18 - 30 31≤
18> 18 - 30 31≤
Risk Score for Age 40 - 50 (n=26) 3 2 3
28 10 9
18> 18 - 30 31≤ 38% 25% 38%
60% 21% 19%
16 6 4
62% 23% 15% Patients Over 50 n=13
METHOD: In Oncotype DX assay, patients are stratified into 3 groups
according to their risk scores: 18> indicates that the patient has a low Postmenapousal patients make 28% (n=13) of the study group and their
risk of recurrence (the patient will certainly benefit much from hormonal results are correlated with the ones in perimenapousal group. 69% of the 80%
therapy rather than chemotherapy), a risk score of 18 – 30 means that women (n=9) in low risk group anticipate limited benefit of chemotherapy
the recurrence is at intermediate risk, 30 18 - 30 31≤
except one of them are ER positive. The total risk score analysis show
Risk Score Over 50 (n=13)
that: 60% of all the women are in low risk group, 21% of them are 18> 18 - 30 31≤
intermediate and only 19% of the patients are supposed to benefit from CONCLUSION: Our analysis show that every 6 patient out of 10 will
chemotherapy. This data concludes that 6 out of 10 women expect to 9 2 2 have less benefit from chemotherapy. Considering the social and
have lower therapeutic effect from chemotherapy. economic burden of chemotherapy both for the patient and the
69% 15% 15% caregiver, Oncotype DX may be an alternative approach.