Endocrine therapy initiation, discontinuation and adherence and breast imaging among 21-gene recurrence score assay-eligible women under age 65.

Background: Aside from chemotherapy utilization, limited data are available on the relationship between gene expression profiling (GEP) testing and breast cancer care. We assessed the relationship between GEP testing and additional variables and the outcomes of endocrine therapy initiation, disconti...

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Publicado en:Breast Cancer Research Vol. 19; pp. 1 - 14
Autores principales: O'Neill, Suzanne C., Isaacs, Claudine, Lynce, Filipa, Graham, Deena Mary Atieh, Chao, Calvin, Sheppard, Vanessa B., Yingjun Zhou, Chunfu Liu, Selvam, Nandini, Schwartz, Marc D., Potosky, Arnold L., Zhou, Yingjun, Liu, Chunfu
Formato: research tables/charts Journal Article
Publicado: BioMed Central 3/31/2017
Acceso en línea:Ver este registro en EBSCOhost
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        14655411
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      jtl: Breast Cancer Research
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      dt: 3/31/2017
      vid: 19
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      pub: BioMed Central
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        10.1186/s13058-017-0837-2
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      tig:
        atl: Endocrine therapy initiation, discontinuation and adherence and breast imaging among 21-gene recurrence score assay-eligible women under age 65.
      aug:
        au:
          O'Neill, Suzanne C.
          Isaacs, Claudine
          Lynce, Filipa
          Graham, Deena Mary Atieh
          Chao, Calvin
          Sheppard, Vanessa B.
          Yingjun Zhou
          Chunfu Liu
          Selvam, Nandini
          Schwartz, Marc D.
          Potosky, Arnold L.
          Zhou, Yingjun
          Liu, Chunfu
        affil: Georgetown Lombardi Comprehensive Cancer Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007, USA
      sug:
        subj:
          Gene Expression Profiling
          Breast Neoplasms
          Odds Ratio
          Aged, 80 and Over
          Neoplasm Staging
          Aged
          Breast Neoplasms Mortality
          Chemotherapy, Adjuvant
          Female
          Recurrence
          Young Adult
          Kaplan-Meier Estimator
          Breast Neoplasms Drug Therapy
          Adult
          Medication Compliance
          Middle Age
          Age Factors
          Risk Factors
          Funding Source
          Human
          Aged, 80 & over
          Aged: 65+ years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
      ab: Background: Aside from chemotherapy utilization, limited data are available on the relationship between gene expression profiling (GEP) testing and breast cancer care. We assessed the relationship between GEP testing and additional variables and the outcomes of endocrine therapy initiation, discontinuation and adherence, and breast imaging exams in women under age 65 years.Methods: Data from five state cancer registries were linked with claims data and GEP results. We assessed variables associated with survivorship care outcomes in an incident cohort of 5014 commercially insured women under age 65 years, newly diagnosed with stage I or II hormone-receptor-positive, human epidermal growth factor receptor 2 (HER2) non-positive breast cancer from 2006 to 2010.Results: Among tested women, those with high Oncotype DX® Breast Recurrence Score® (RS) were significantly less likely to initiate endocrine therapy than women with low RS tumors (OR 0.40 (95% CI 0.20 to 0.81); P = 0.01). Among all test-eligible women, receipt of Oncotype DX testing was associated with a greater likelihood of endocrine therapy initiation (OR 2.48 (95% CI 2.03 to 3.04); P <0.0001). The odds of initiation were also significantly higher for tested vs. untested women among women who did not initiate chemotherapy within six months of diagnosis (OR 3.25 (95% CI 2.53 to 4.16)), with no effect in women who received chemotherapy. Discontinuation and adherence and breast imaging exams were unrelated to tested status or RS.Conclusions: Lower endocrine therapy initiation rates among women with high RS tumors and among untested women not receiving chemotherapy are concerning, given its established efficacy. Additional research is needed to suggest mechanisms to close this gap.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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