Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial.
| Title: | Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial. |
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| Authors: | Robertson SJ; Eastern Ontario Regional Laboratory Association and Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Canada.; Ibrahim MFK; Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.; Stober C; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.; Hilton J; Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.; Kos Z; Eastern Ontario Regional Laboratory Association and Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Canada.; Mazzarello S; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.; Ramsay T; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.; School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada.; Fergusson D; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.; School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada.; Vandermeer L; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.; Mallick R; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.; Arnaout A; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.; School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada.; Division of Surgical Oncology, Department of Surgery, The Ottawa Hospital and University of Ottawa, Ottawa, Canada.; Dent SF; Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.; Segal R; Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.; Sehdev S; Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.; Gertler S; Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.; Hutton B; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.; School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada.; Clemons M; Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.; School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada. |
| Source: | Journal of evaluation in clinical practice [J Eval Clin Pract] 2019 Apr; Vol. 25 (2), pp. 196-204. Date of Electronic Publication: 2019 Jan 23. |
| Publication Type: | Journal Article; Randomized Controlled Trial |
| Language: | English |
| Journal Info: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9609066 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2753 (Electronic) Linking ISSN: 13561294 NLM ISO Abbreviation: J Eval Clin Pract |
| Imprint Name(s): | Original Publication: Oxford, England : Wiley-Blackwell, c1995- |
| MeSH Terms: | Clinical Decision-Making* ; Diagnostic Tests, Routine* ; Medical Oncology*; Breast Neoplasms/*classification; Breast Neoplasms/drug therapy ; Aged ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; Prospective Studies ; Surveys and Questionnaires |
| Abstract: | Objective: The three Magee Equations provide an estimate of the Oncotype DX recurrence score using commonly available clinicopathologic information (tumour size, grade, oestrogen receptor, progesterone receptor, HER2, and Ki67). We assessed whether integration of Magee Equations into routine clinical practice affected the frequency of Oncotype DX requests.; Methods: Patients with newly diagnosed, node negative, hormone receptor positive, and HER2 negative invasive breast cancer were randomized to undergo a Magee calculation or not. At the first clinic assessment, the oncologist was provided with all routinely available clinicopathologic information (including Ki67) either with or without the results of Magee Equations. Primary outcome was frequency of Oncotype DX ordering. Secondary outcomes included frequency of chemotherapy use, time to commencement of radiotherapy, or systemic therapy. Physician comfort with systemic therapy choices and the use of Ki67 and Magee Equations was also assessed.; Results: Data from 175 randomized patients was available, 84 patients (48%) with and 91 (52%) without calculated Magee Equations. Oncotype DX was ordered in 10 (12.05%) and 13 (14.44%) (RR 0.83, 0.39-1.80; P = 0.64) in the Magee and no Magee groups, respectively. There were no statistically or clinically significant differences between the randomized groups for any of the secondary outcomes. Availability of both Ki67 and Magee Equations was associated with increased physician comfort around systemic treatment decisions.; Conclusions: In a practice where Ki67 is routinely available, addition of Magee Equations into routine clinic practice was not associated with a reduction in Oncotype DX use. Availability of both Ki67 and Magee Equations did however increase physician comfort with systemic therapy decisions.; (© 2019 John Wiley & Sons, Ltd.) |
| Contributed Indexing: | Keywords: Magee equations; Oncotype DX; breast cancer |
| Entry Date(s): | Date Created: 20190124 Date Completed: 20190730 Latest Revision: 20190730 |
| Update Code: | 20260130 |
| DOI: | 10.1111/jep.13094 |
| PMID: | 30672056 |
| Database: | MEDLINE |
Journal Article; Randomized Controlled Trial