Can we reduce chemotherapy costs in breast cancer by using gene expression assays

Introduction: Breast cancer is the most common cancer in women, which adjuvant treatments impose a financial burden on the health care system and patients. So, identifying patients for whom chemotherapy would be beneficial can reduce unnecessary services and costs. Oncotype DX testing is the prognostic assay that predicts the likelihood of chemotherapy benefit in breast cancer as well as the risk of distant recurrence. Methods: This study, based on rapid health technology assessment, explored the use of Oncotype in the prognosis of breast cancer compared to alternative methods in terms of effectiveness and economic consequences. PubMed, Scopus, Web of Science and Cochrane databases have been searched and only studies about the use of the Oncotype test in breast cancer have been included. Results and Discussion: The results of the 32 related studies showed that the difference in outcomes was negligible cross Oncotype and other gene expression profiling tests, but these differences were significant compared to standard treatment. Also, Oncotype testing will be cost-saving when used for patients under chemotherapy. However, using this test for all patients may not be cost-saving depending on the number of patients who switch from hormone therapy to chemotherapy and vice versa. Conclusion: Using gene expression assays such as Oncotype could be helpful in decision making about treatment, especially in including or not chemotherapy as part of the treatment plan

Keywords:

breast cancer , chemotherapy , Oncotype DX , cost