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01-05-2019 | Breast Cancer | Gynecologic Oncology

The impact of EndoPredict ^® on decision making with increasing oncological work experience: can overtreatment be avoided?

Authors: Fabinshy Thangarajah, Christian Eichler, Julia Fromme, Wolfram Malter, Julia Caroline Radosa, Sebastian Ludwig, Julian Puppe, Stefan Paepke, Matthias Warm

Published in: Archives of Gynecology and Obstetrics | Issue 5/2019

Abstract

Background

Estimating distant recurrence risk in women with estrogen receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer is still challenging. EndoPredict^® is a gene expression-based test predicting the likelihood of recurrent disease. We analyzed the difference in oncological decision making with and without the knowledge of gene expression tests.

Patients and methods

This is a retrospective analysis including patients diagnosed with hormone-receptor positive, Her2 negative breast cancer between 2011 and 2015 at the Municipal Breast Cancer Centre Cologne, Germany. All patients received an evaluation by EndoPredict^®. An oncological tumor board (TB) with knowledge of these results served as a baseline (control group). This baseline was compared to the treatment decision (adjuvant chemotherapy yes vs. no) made by oncologists with different experience levels (less than 5 years, between 5 and 15 years, and more than 15 years) who were not provided the EndoPredict^® scores. All clinicians had access to clinical as well to histopathological data.

Results

There was no significant difference between control group and the oncologists with different experience levels concerning a chemotherapy indication. A trend could be shown in the subgroup of nodal negative patients between the treatment recommendation and physicians with more than 15 years of experience (p = 0.088). A further trend could be demonstrated in the subgroup of patients with a low Ki67 index (≤ 14%) (p = 0.063) between physician with 5–10 years of clinical experience and official treatment recommendation.

Conclusion

It seems that inexperienced physicians may profit from the use of EndoPredict^® to avoid an overtreatment. In nodal negative patients and patients with a low Ki67 index, undertreatment can be avoided with the use of EndoPredict^® (borderline significance). Further prospective studies with larger study cohorts are needed to further validate this tool.

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Title: The impact of EndoPredict ® on decision making with increasing oncological work experience: can overtreatment be avoided?
Authors: Fabinshy Thangarajah
Christian Eichler
Julia Fromme
Wolfram Malter
Julia Caroline Radosa
Sebastian Ludwig
Julian Puppe
Stefan Paepke
Matthias Warm
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keywords: Breast Cancer
Breast Cancer
Cytostatic Therapy
Published in: Archives of Gynecology and Obstetrics / Issue 5/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05097-w

At a glance: The STEP trials

Springer Medicine

The impact of EndoPredict ^® on decision making with increasing oncological work experience: can overtreatment be avoided?

Abstract

Background

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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