L M McSorley1, M Tharmabala2, F Al Rahbi3, K McSorley4, S Chew2, D Evoy4, J G Geraghty4, R S Prichard4, J Rothwell4, D P McCartan4, E W McDermott4, M Keane5, M J Kennedy6, S O'Reilly7, S J Millen8, J P Crown2, L M Smyth2,9, C M Kelly10, C M Quinn3,11, J M Walshe2,11. 1. Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland. Lyndamcsorley1@gmail.com. 2. Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland. 3. Department of Pathology, St. Vincent's University Hospital, Dublin, Ireland. 4. Department of Surgery/Breast Surgery, St. Vincent's University Hospital, Dublin, Ireland. 5. Department of Medical Oncology, Galway University Hospitals, Galway, Ireland. 6. Department of Medical Oncology, St James's Hospital, Dublin, Ireland. 7. Department of Medical Oncology, Cork University Hospital, Cork, Ireland. 8. Exact Sciences UK Ltd, London, UK. 9. Loxo Oncology Inc., Stamford, CT, USA. 10. Department of Medical Oncology, The Mater Misericordiae University Hospital, Dublin, Ireland. 11. University College Dublin, Dublin, Ireland.
Abstract
PURPOSE: Results from TAILOR-X suggest that up to 70% of hormone receptor-positive (HR+) node-negative (N0) ESBC patients (pts) may avoid chemotherapy (CT) with RS ≤ 25. We assess clinical and economic impacts of RS testing on treatment using real-world data. METHODS: From October 2011 to February 2019, a retrospective, cross-sectional observational study was conducted of HR+ N0 ESBC pts who had RS testing in Ireland. Pts were classified low risk (RS ≤ 25) and high risk (RS > 25). Clinical risk was calculated. Data were collected via electronic patient records. Cost data were supplied by the National Healthcare Pricing Regulatory Authority. RESULTS: 963 pts. Mean age is 56 years. Mean tumour size is 1.7 cm. 114 (11.8%), 635 (66%), 211 (22%), 3 (0.2%) pts had G1, G2, G3 and unknown G, respectively. 796 pts (82.8%) low RS, 159 (16.5%) high RS and 8 pts (0.7%) unknown RS. 263 pts (26%) were aged ≤ 50 at diagnosis; 117 (45%) had RS 0-15, 63 (24.5%) 16-20, 39 (15.3%) 21-25 and 40 (15.2%) RS 26-100. 4 pts (1.5%) had unknown RS. Post-RS testing, 602 pts (62.5%) had a change in CT decision; 593 changed to hormone therapy (HT) alone. In total, 262 pts received CT. Of pts receiving CT; 138 (53%) had RS > 25, 124 (47%) had RS ≤ 25. Of pts aged ≤ 50, 153 (58%) had high clinical risk, of whom 28 had RS 16-20. Assay use achieved a 62.5% change in treatment with 73% of pts avoiding CT. This resulted in savings of €4 million in treatment costs. Deducting assay costs, savings of €1.9 million were achieved. CONCLUSION: Over the 8 years of the study, a 62.5% reduction in CT use was achieved with savings of over €1,900,000.
PURPOSE: Results from TAILOR-X suggest that up to 70% of hormone receptor-positive (HR+) node-negative (N0) ESBC patients (pts) may avoid chemotherapy (CT) with RS ≤ 25. We assess clinical and economic impacts of RS testing on treatment using real-world data. METHODS: From October 2011 to February 2019, a retrospective, cross-sectional observational study was conducted of HR+ N0 ESBC pts who had RS testing in Ireland. Pts were classified low risk (RS ≤ 25) and high risk (RS > 25). Clinical risk was calculated. Data were collected via electronic patient records. Cost data were supplied by the National Healthcare Pricing Regulatory Authority. RESULTS: 963 pts. Mean age is 56 years. Mean tumour size is 1.7 cm. 114 (11.8%), 635 (66%), 211 (22%), 3 (0.2%) pts had G1, G2, G3 and unknown G, respectively. 796 pts (82.8%) low RS, 159 (16.5%) high RS and 8 pts (0.7%) unknown RS. 263 pts (26%) were aged ≤ 50 at diagnosis; 117 (45%) had RS 0-15, 63 (24.5%) 16-20, 39 (15.3%) 21-25 and 40 (15.2%) RS 26-100. 4 pts (1.5%) had unknown RS. Post-RS testing, 602 pts (62.5%) had a change in CT decision; 593 changed to hormone therapy (HT) alone. In total, 262 pts received CT. Of pts receiving CT; 138 (53%) had RS > 25, 124 (47%) had RS ≤ 25. Of pts aged ≤ 50, 153 (58%) had high clinical risk, of whom 28 had RS 16-20. Assay use achieved a 62.5% change in treatment with 73% of pts avoiding CT. This resulted in savings of €4 million in treatment costs. Deducting assay costs, savings of €1.9 million were achieved. CONCLUSION: Over the 8 years of the study, a 62.5% reduction in CT use was achieved with savings of over €1,900,000.
Authors: F Cardoso; S Kyriakides; S Ohno; F Penault-Llorca; P Poortmans; I T Rubio; S Zackrisson; E Senkus Journal: Ann Oncol Date: 2019-08-01 Impact factor: 32.976
Authors: Lyndsay N Harris; Nofisat Ismaila; Lisa M McShane; Fabrice Andre; Deborah E Collyar; Ana M Gonzalez-Angulo; Elizabeth H Hammond; Nicole M Kuderer; Minetta C Liu; Robert G Mennel; Catherine Van Poznak; Robert C Bast; Daniel F Hayes Journal: J Clin Oncol Date: 2016-02-08 Impact factor: 44.544
Authors: Fatima Cardoso; Laura J van't Veer; Jan Bogaerts; Leen Slaets; Giuseppe Viale; Suzette Delaloge; Jean-Yves Pierga; Etienne Brain; Sylvain Causeret; Mauro DeLorenzi; Annuska M Glas; Vassilis Golfinopoulos; Theodora Goulioti; Susan Knox; Erika Matos; Bart Meulemans; Peter A Neijenhuis; Ulrike Nitz; Rodolfo Passalacqua; Peter Ravdin; Isabel T Rubio; Mahasti Saghatchian; Tineke J Smilde; Christos Sotiriou; Lisette Stork; Carolyn Straehle; Geraldine Thomas; Alastair M Thompson; Jacobus M van der Hoeven; Peter Vuylsteke; René Bernards; Konstantinos Tryfonidis; Emiel Rutgers; Martine Piccart Journal: N Engl J Med Date: 2016-08-25 Impact factor: 91.245
Authors: Martin Filipits; Torsten O Nielsen; Margaretha Rudas; Richard Greil; Herbert Stöger; Raimund Jakesz; Zsuzsanna Bago-Horvath; Otto Dietze; Peter Regitnig; Christine Gruber-Rossipal; Elisabeth Müller-Holzner; Christian F Singer; Brigitte Mlineritsch; Peter Dubsky; Thomas Bauernhofer; Michael Hubalek; Michael Knauer; Harald Trapl; Christian Fesl; Carl Schaper; Sean Ferree; Shuzhen Liu; J Wayne Cowens; Michael Gnant Journal: Clin Cancer Res Date: 2014-02-11 Impact factor: 12.531
Authors: James J Dignam; Vanja Dukic; Stewart J Anderson; Eleftherios P Mamounas; D Lawrence Wickerham; Norman Wolmark Journal: Breast Cancer Res Treat Date: 2008-10-02 Impact factor: 4.872
Authors: P Dubsky; J C Brase; R Jakesz; M Rudas; C F Singer; R Greil; O Dietze; I Luisser; E Klug; R Sedivy; M Bachner; D Mayr; M Schmidt; M C Gehrmann; C Petry; K E Weber; K Fisch; R Kronenwett; M Gnant; M Filipits Journal: Br J Cancer Date: 2013-10-24 Impact factor: 7.640
Authors: Miguel Martin; Jan C Brase; Lourdes Calvo; Kristin Krappmann; Manuel Ruiz-Borrego; Karin Fisch; Amparo Ruiz; Karsten E Weber; Blanca Munarriz; Christoph Petry; Cesar A Rodriguez; Ralf Kronenwett; Carmen Crespo; Emilio Alba; Eva Carrasco; Maribel Casas; Rosalia Caballero; Alvaro Rodriguez-Lescure Journal: Breast Cancer Res Date: 2014-04-12 Impact factor: 6.466