Oncotype DX definitely produced a winner with its Breast Cancer Assay. Here are the results of the test according to the company web site:
- 33% [of tested patients] switched from chemotherapy + hormone therapy to hormone therapy alone based on a low Recurrence Score result
- 4% [of tested patients] switched from hormonal therapy only to chemotherapy + hormonal therapy based on a high Recurrence Score result
The company is now introducing a new assay for assessing the risk of biopsied prostate cancer (see: New Test Improves Assessment of Prostate Cancer Risk, Study Says). Here's an excerpt from a recent article discussing this new test:
A new test can help distinguish aggressive prostate cancer from less threatening ones, potentially saving many men from unneeded operations for tumors that would never hurt them, researchers are reporting....Results of a study assessing the test’s performance will be presented...at the annual meeting of the American Urological Association in San Diego....Still, some experts said it was too early to assess how accurate the test [developed by Genomic Health] really was and whether it would make a difference in men’s decisions. Insurers are going to want to know that before deciding to pay for the test...at a list price of $3,820....The new test, which is called the Oncotype DX Prostate Cancer Test, is one of more than a dozen coming to market that use advanced genetic methods to help better manage prostate cancer....[Genomic Health] already sells a similar test for breast cancer, also Oncotype DX, that is widely used to help women decide whether they can forgo chemotherapy after their tumor is surgically removed....
The test looks at the activity level of 17 genes in the biopsy sample and computes a score from 0 to 100 showing the risk that cancer is aggressive.To see how well the test worked, testing was performed on archived biopsy samples from 412 patients who had what was considered low or intermediate-risk cancer but then underwent surgery. In many such cases, the tumor, which can be closely studied after it is surgically removed, turns out to be more aggressive than thought based on the biopsy, which looks at only a tiny sample of the tumor.The researchers found that the Oncotype test predicted such unfavorable pathology more accurately than existing methods, which depend mainly on the Gleason score based on how the biopsy sample looks under the microscope. Genomic Health said that 26 percent of the samples were classified as very low risk by its test, compared to only 5 to 10 percent for the existing methods. In some cases, however, the new test showed the cancer to be more aggressive than the existing methods.
We'll see how all of this works out. The company certainly has momentum and experience on its side with its earlier breast cancer test. These two tests represent the first generation of tests for determining the genetic fingerprints of tumors deemed malignant by pathologists but which may act in varying ways clinically. There will be more of such tests in the future, each of which should be more accurate as the experience increases. The list price for the prostate cancer test is stiff but certainly worth it for the lucky patients who may be able to avoid the more aggressive surgery and chemotherapy regimens.