Prospective study of the decision-making impact of the Breast Cancer Index in the selection of patients with ER+ breast cancer for extended endocrine therapy.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 538-538
Author(s):  
Tara Beth Sanft ◽  
Bilge Aktas ◽  
Brock Schroeder ◽  
Veerle Bossuyt ◽  
Michael DiGiovanna ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Prospective Study ◽  
Endocrine Therapy ◽  
Breast Cancer Index ◽  
Extended Endocrine Therapy ◽  
Selection Of Patients ◽  
Selection Of

scholarly journals A prospective decision-impact study incorporating Breast Cancer Index into extended endocrine therapy decision-making

2019 ◽  
Vol 8 (1) ◽  
pp. BMT22
Author(s):  
Tara Sanft ◽  
Alyssa Berkowitz ◽  
Brock Schroeder ◽  
Christos Hatzis ◽  
Catherine A Schnabel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Endocrine Therapy ◽  
Impact Study ◽  
Therapy Decision ◽  
Breast Cancer Index ◽  
Extended Endocrine Therapy

Estrogen Receptor in Human Breast Cancer in Relation to Tumor Morphology and Endocrine Therapy

1978 ◽  
Vol 64 (5) ◽  
pp. 495-506 ◽  
Author(s):  
Zygmunt Paszko ◽  
Halina Padzik ◽  
Maria Dabska ◽  
Feliksa Pienkowska
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Human Breast Cancer ◽  
Tumor Tissue ◽  
Human Breast ◽  
Histological Grading ◽  
Er Positive ◽  
Estrogen Binding ◽  
Selection Of Patients ◽  
Selection Of

The presence of estrogen receptors (ER) was determined in 111 human breast cancer specimens. In 61 % of the tumors, specific estrogen binding was found and in 39 % of the tumors ER was absent. In 69 tumors no correlation was found between the histological grading of the tumor and the level of ER. The values of ER in tumors from patients over 50 years of age were usually much higher than those for patients under 50 years of age. Different methods of endocrine therapy were applied in 20 patients. In 10 of 15 patients with ER positive tumors, endocrine therapy resulted in remission. Only 1 of 5 patients with ER negative tumors responded with remission. It is concluded that estimation of ER in tumor tissue is helpful in the selection of patients for endocrine therapy.

Health economic analysis of breast cancer index in patients with ER+, LN- breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11504-e11504
Author(s):  
Gary Gustavsen ◽  
Brock Schroeder ◽  
Patrick Kennedy ◽  
Kristin Ciriello Pothier ◽  
Catherine A. Schnabel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Adjuvant Chemotherapy ◽  
Endocrine Therapy ◽  
Cost Savings ◽  
Cost Utility ◽  
Sensitivity Analyses ◽  
Breast Cancer Index ◽  
Extended Endocrine Therapy ◽  
The Cost

e11504 Background: Numerous studies have demonstrated the cost utility of gene expression-based assessment of recurrence risk in breast cancer. Cost savings rely primarily on decreased use of adjuvant chemotherapy in patients predicted to be low-risk. Breast Cancer Index (BCI) is a gene expression-based test that significantly predicts overall risk of recurrence, late (≥5y) recurrence and likelihood of benefit from extended (≥5y) endocrine therapy in patients with ER+, LN- breast cancer. This study evaluated the potential cost utility of BCI from a US third-party payer perspective. Methods: A fact-based economic model was developed which projected the cost and effectiveness of BCI in a hypothetical population of patients with ER+, LN- breast cancer compared to standard clinicopathologic diagnostic modalities. Patients flowed through the model based on patterns of care and BCI data. Costs associated with adjuvant chemotherapy, toxicity, follow-up, endocrine therapy, and recurrence were modeled over 10 yrs. Model inputs were based primarily on published literature, and supplemented by interviews with disease experts and payers. Sensitivity analyses were performed around key inputs to estimate effects on the model. Results: Use of BCI is projected to be cost saving in this patient population, with a net cost savings of $4,005 per patient tested after accounting for BCI cost. Gross cost savings were projected to be achieved through targeted use of adjuvant chemotherapy ($5,785), reduced recurrence in patients receiving extended endocrine therapy based on BCI ($2,350), and reduced recurrence in previously non-compliant patients ($370). Sensitivity analyses demonstrated that results were most sensitive to chemotherapy utilization in low- and intermediate-risk patients, cost of adjuvant chemotherapy, cost of recurrence, and percentage of patients classified as low risk. Conclusions: BCI is projected to be cost saving in an ER+, LN-, breast cancer patient population. Cost savings are achieved through projected impact on adjuvant chemotherapy use, extended endocrine therapy use, and endocrine therapy compliance. These findings require validation in additional cohorts, including studies of real-world clinical practice.

Breast Cancer Index and prediction of benefit from extended endocrine therapy based on treatment compliance: An IDEAL study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 531-531
Author(s):  
Gerrit-Jan Liefers ◽  
Iris Noordhoek ◽  
Kai Treuner ◽  
Hein Putter ◽  
Jenna Wong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Treatment Compliance ◽  
Significant Benefit ◽  
Endocrine Treatment ◽  
Breast Cancer Patients ◽  
Absolute Benefit ◽  
Breast Cancer Index ◽  
Extended Endocrine Therapy ◽  
The Ideal

531 Background: The IDEAL trial randomized hormone receptor-positive (HR+) breast cancer patients to 5 vs 2.5y of extended letrozole after completion of 5y of adjuvant endocrine therapy. In the parent trial, approximately 60% of patients overall were compliant with endocrine treatment (59% vs 74% compliance in 5y and 2.5y arms, respectively), with patient experiences as the most significant factors leading to treatment discontinuation. Breast Cancer Index is a gene expression-based signature that predicts which HR+ patients are likely to benefit from extended endocrine therapy (EET) vs those unlikely to benefit [BCI (H/I)-High and -Low, respectively]. The current study examined EET compliance and outcome by BCI (H/I) status in patients treated in the IDEAL trial. Methods: Patients with available primary tumor specimens were eligible for this blinded study. Primary endpoint was recurrence-free interval (RFI), including locoregional and distant recurrences. Kaplan-Meier and Cox proportional hazards regression analysis were used to analyze the benefit of EET. Non-compliance was defined as completion of ≤60% of treatment duration (≤3y for 5y arm; ≤1.5y for 2.5y arm) for any reason other than disease events. Overtreatment was defined as % compliant BCI (H/I)-Low patients in the 5y arm; undertreatment was % noncompliant BCI (H/I)-High patients in the 5y arm. Results: 908 HR+ patients (73% pN+, 59y, 45% pT1, 48% pT2) were included. 78% (n = 708) of patients were compliant, of which 48% (n = 338) were BCI (H/I)-High and 52% (n = 370) were BCI (H/I)-Low. In non-compliant patients (22%, n = 200), 45% (n = 91) were BCI (H/I)-High and 55% (n = 109) were BCI (H/I)-Low. BCI (H/I)-Low patients irrespective of compliance status did not derive significant benefit from EET (P = 0.922, compliant subset; 0.894 non-compliant subset). Compliant BCI (H/I)-High patients showed significant benefit from EET (HR 0.35, 95% CI 0.16-0.79; absolute benefit 11.7%; P = 0.008) whereas non-compliant BCI (H/I)-High patients did not (HR 0.75, 95% CI 0.17-3.35; absolute benefit 2.1%, P = 0.704). In this study, 38% of patients in the 5y EET arm were BCI (H/I)-Low and compliant and thus were overtreated, while 13% of patients in the 5y EET arm were BCI (H/I)-High and non-compliant and thus were undertreated. Conclusions: Patients that were BCI (H/I)-Low did not derive significant benefit from 5 vs 2.5y of EET even when compliant, and thus may be considered for treatment de-escalation. Importantly, BCI (H/I)-High patients with endocrine responsive disease showed significant improvements in outcome when compliant and should be guided to continue treatment. BCI may serve as an important genomic tool to increase EET compliance and identify patients that may be candidates for increased side effect management and support to potentially improve outcomes. Clinical trial information: NTR3077; BOOG 2006-05; Eudra-CT 2006-003958-16.

Sign in / Sign up

Export Citation Format

Share Document