Effect of the 12-gene colon cancer assay results on adjuvant treatment recommendations in patients with stage II colon cancer. (February 2014)

• Record Type: Journal Article
• Authors: Cartwright, T.; Chao, C.; Lee, M.; Lopatin, M.; Bentley, T.; Broder, M.; Chang, E.
• Is Part Of: Current medical research and opinion. Volume 30:Number 2(2014:Feb.)
• Page Start: 321
• Page End: 328
• Publication Date: 2014-02
• Subjects: Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1185/03007995.2013.855183
• Languages: English
• ISSNs: 0300-7995

Abstract

<abstract> <title>Abstract</title> <sec id="ss1"> <title>Introduction:</title> <p>The 12-gene colon cancer Recurrence Score assay is a clinically validated predictor of recurrence risk in stage II colon cancer patients. A survey was performed characterizing the assay's impact on treatment recommendations for these patients.</p> </sec> <sec id="ss2"> <title>Methods:</title> <p>US medical oncologists (<italic>n</italic> = 346) who ordered the assay for ≥3 stage II colon cancer patients were asked to complete a web-based survey regarding their most recent such patient. Physicians surveyed represented users of the assay within the first 2 years of commercial availability which may include 'early adopters'.</p> </sec> <sec id="ss3"> <title>Results:</title> <p>Most of 116 eligible physicians were in community practice (86%), with median 14.5 years' experience (range = 2–40). Mean patient age was 61 years (range = 32–85); 81% had T3 disease, and 38% had comorbidities. Of 76 patients tested for mismatch-repair/microsatellite-instability (MMR/MSI), 13 (17%) were MMR-deficient/MSI-high; 46 (61%) MMR-proficient/MSI-low; and 17 (22%) unknown. Most patients (84%) had ≥12 nodes examined. Median Recurrence Score result was 20 (range = 1–77). Before assay, treatment recommendations were specified for 92 (79%) patients, with no recommendation for 24 (21%). Of the 92 with pre-assay recommendations, chemotherapy was planned for 52 (57%) and observation for 40 (43%); the assay changed recommendations for 27 (29%). Treatment intensity decreased for 18 (67%) and increased for nine (33%) patients; it was more likely to decrease for lower Recurrence Score values and increase for higher values (<italic>p</italic> < 0.001).</p> </sec> <sec id="ss4"> <title>Conclusion:</title> <p>For stage II colon cancer patients receiving Recurrence Score testing, 29% of treatment recommendations were changed. Use of the assay may lead to reductions in treatment intensity. Study limitations include retrospective design, data gathering during the first 2 years of assay availability only, and potential non-representativeness of respondents.</p> </sec> </abstract>