Similarly, results from a prospective study of more than 700 patients tested with Oncotype DX within Clalit Health Services, the largest health maintenance organization in Israel, showed that patients with micrometastases or one to three positive lymph nodes and a RS less than 18, the vast majority (92.9 percent) of whom were treated with hormonal therapy alone, had very good outcomes with low rates of distant recurrence (3.2 percent) and excellent breast cancer survival (>99 percent) at five years.

"These two important updates add significantly to the growing body of evidence that Oncotype DX accurately predicts outcomes and aids treatment decision making in women with early-stage, node-positive breast cancer. Just as we have learned in node-negative disease, it is now increasingly evident that women with one to three positive nodes and the lower scores do extremely well without chemotherapy," said Kathy S. Albain, MD, FACP, FASCO, professor of medicine, Loyola University Chicago, Cardinal Bernardin Cancer Center, Maywood, IL. "While we are now completing accrual of the RxPONDER trial looking at whether chemotherapy adds to standard endocrine therapy in this group, getting the results will take several years. In the meantime, these data along with previously published results, provide extremely strong evidence to justify use of Oncotype DX in 1-3 node-positive disease. If the patient's tumor biology is that of a low Recurrence Score, chemotherapy simply does not add benefit, and its risks and costs can be avoided."


In addition, exploratory analyses of patients with RS results of 18 to 30 showed that the rate of distant recurrence were generally closer to lower risk patients with a RS less than 18. The group of patients with mid-range Recurrence Score results is also being studied in the Trial Assigning IndividuaLized Options for Treatment (Rx), or TAILORx, and the RxPONDER trial.

Oral presentation of additional SEER analysis reveals large disparities in survival and Oncotype DX testing in older patients
Following up on the results of the multinational TEAM study, which reported worse outcomes for older patients with hormone-receptor-positive (HR+) breast cancer, this study examined RS results in patients 70 years and older versus those under 70 years. The results showed that mortality was indeed much higher in older patients who were either not tested with Oncotype DX or had a RS result greater than 18. Patients age 70 or older also had lower reported chemotherapy use, supporting continued examination of the often reported issue of under-treatment of the elderly.

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