Baruch Brenner1, Ravit Geva2, Megan Rothney3, Alexander Beny4, Ygael Dror5, Mariana Steiner6, Ayala Hubert7, Efraim Idelevich8, Alexander Gluzman9, Ofer Purim10, Einat Shacham-Shmueli11, Katerina Shulman12, Moshe Mishaeli5, Sophia Man9, Lior Soussan-Gutman13, Haluk Tezcan3, Calvin Chao3, Adi Shani11, Nicky Liebermann14. 1. Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, affiliated with Sackler School of Medicine, Tel Aviv, Israel. Electronic address: brennerb@clalit.org.il. 2. Division of Oncology, Sourasky Medical Center, Tel Aviv, Israel. 3. Genomic Health Inc., Redwood City, CA, USA. 4. Department of Oncology, Rambam Medical Center, Haifa, Israel. 5. Oncology Department, Meir Medical Center, Kfar Saba, Israel. 6. Department of Oncology, Carmel Hospital, Haifa, Israel. 7. Sharett Institute of Oncology, Hadassah-Hebrew University Hospital, Jerusalem, Israel. 8. Institute of Oncology, Kaplan Medical Center, Rehovot, Israel. 9. Department of Clinical Oncology and Radiology, Soroka University Medical Center, Beer Sheva, Israel. 10. Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, affiliated with Sackler School of Medicine, Tel Aviv, Israel. 11. Department of Oncology, Sheba Medical Center, Ramat Gan, Israel. 12. Oncology Unit, Hillel Yaffe Medical Center, Hadera, Israel. 13. Oncotest-Teva Pharmaceutical Industries Ltd., Shoham, Israel. 14. Community Division, Clalit Health Services, Tel Aviv, Israel.
Abstract
OBJECTIVES: To evaluate the impact of the 12-gene Colon Cancer Recurrence Score Assay-a clinically validated prognosticator in stage II colon cancer after surgical resection-on adjuvant treatment decisions in T3 mismatch repair proficient (MMR-P) stage II colon cancer in clinical practice. METHODS: This retrospective analysis included all patients with T3 MMR-P stage II colon cancer (Clalit Health Services members) with Recurrence Score results (time frame January 2011 to May 2012). Treatment recommendations pretesting were compared with the treatments received. Changes were categorized as decreased (to observation alone/removing oxaliplatin from the therapy) or increased (from observation alone/adding oxaliplatin to the therapy) intensity. RESULTS: The analysis included 269 patients; 58%, 32%, and 10% of the values were in the low (<30), intermediate (30-40), and high (≥41) score groups, respectively. In 102 patients (38%), treatment changed post-testing (decreased/increased intensity 76/26 patients). The overall impact was decreased chemotherapy use (45.0% to 27.9%; P < 0.001). Treatment changes occurred in all score groups, but more frequently in the high (change rate 63.0%; 95% confidence interval [CI] 42.3%-80.6%) than in the intermediate (30.6%; 95% CI 21.0%-41.5%) and low (37.6%; 95% CI 30.0%-45.7%) score groups. The direction of the change was consistent with the assay result, with increased intensity more common in higher score values and decreased intensity more common in lower score values. CONCLUSIONS: Testing significantly affected adjuvant treatment in T3 MMR-P stage II colon cancer in clinical practice. The study is limited by its design, which compared treatment recommendations pretesting to actual treatments received post-testing, lack of a control group, and nonassessment of confounding factors that may have affected treatment decisions.
OBJECTIVES: To evaluate the impact of the 12-gene Colon Cancer Recurrence Score Assay-a clinically validated prognosticator in stage II colon cancer after surgical resection-on adjuvant treatment decisions in T3 mismatch repair proficient (MMR-P) stage II colon cancer in clinical practice. METHODS: This retrospective analysis included all patients with T3 MMR-P stage II colon cancer (Clalit Health Services members) with Recurrence Score results (time frame January 2011 to May 2012). Treatment recommendations pretesting were compared with the treatments received. Changes were categorized as decreased (to observation alone/removing oxaliplatin from the therapy) or increased (from observation alone/adding oxaliplatin to the therapy) intensity. RESULTS: The analysis included 269 patients; 58%, 32%, and 10% of the values were in the low (<30), intermediate (30-40), and high (≥41) score groups, respectively. In 102 patients (38%), treatment changed post-testing (decreased/increased intensity 76/26 patients). The overall impact was decreased chemotherapy use (45.0% to 27.9%; P < 0.001). Treatment changes occurred in all score groups, but more frequently in the high (change rate 63.0%; 95% confidence interval [CI] 42.3%-80.6%) than in the intermediate (30.6%; 95% CI 21.0%-41.5%) and low (37.6%; 95% CI 30.0%-45.7%) score groups. The direction of the change was consistent with the assay result, with increased intensity more common in higher score values and decreased intensity more common in lower score values. CONCLUSIONS: Testing significantly affected adjuvant treatment in T3 MMR-P stage II colon cancer in clinical practice. The study is limited by its design, which compared treatment recommendations pretesting to actual treatments received post-testing, lack of a control group, and nonassessment of confounding factors that may have affected treatment decisions.
Authors: Benjamin G Allar; Evangelos Messaris; Vitaliy Y Poylin; Benjamin L Schlechter; Thomas E Cataldo Journal: Med Oncol Date: 2022-02-12 Impact factor: 3.064
Authors: Chengfei Jiang; Yue Zhao; Binbin Yuan; Hang Chang; Bo Hang; Antoine M Snijders; Jian-Hua Mao; Xiaoping Zou; Pin Wang Journal: Clin Transl Med Date: 2020-12