The impact of the 21-gene recurrence score assay on decision making about adjuvant chemotherapy in early-stage @entity172 -receptor-positive XXXX in an oncology practice with a unified treatment policy.

@entity172 @entity1 @entity0
BACKGROUND: The 21-gene recurrence score (RS) assay has been validated in retrospective studies as prognostic of distant disease recurrence and predictive of the benefit of adjuvant chemotherapy in @entity172 -receptor-positive @entity0 ( @entity0 ). There is limited published data on the impact of the assay on clinical practice, particularly in the context of a single practice with a unified treatment policy. @entity1 AND METHODS: Between 2006 and 2009, RS was obtained on 135 @entity1 in a single practice with a uniform treatment policy. Treatment recommendations before and after RS result were analyzed retrospectively. Pre-RS treatment recommendations were based on clinicopathological features and Adjuvant! Online (AO) calculated survival advantage. RS and AO survival advantage for adding chemotherapy were compared for each @entity1 . RESULTS: The distribution by risk group of RS was low- 49.6%, intermediate-37.8%, and high-12.6%. In 34 @entity1 (25.2%, 95% confidence interval 17.9% to 32.5%), recommendation for chemotherapy was changed after obtaining assay result. Most changes (70.6%) were from chemotherapy to no chemotherapy. The RS correlated poorly with AO predictions. CONCLUSION: The 21-gene assay, when applied in a consistent manner in early-stage @entity0 , changes treatment recommendations in one-quarter of @entity1 tested.
