It's' a sure bet that any woman with a diagnosis of breast cancer would like to know whether chemotherapy is likely to benefit her before beginning such a regimen. As Rick and I discuss on PodMed this week, and as published in Cancer, that's the aim of the 21-gene recurrence score assay currently employed clinically. The study specifically examines both how the test was able to inform treatment recommendations on the part of physicians as well as patient experience.The good news is that in employing the test in women in whom it is indicated, the gene assay seems to bring to fruition the promise of precision medicine. As well, it appears to be both racially and ethnically blind, as no difference across these groups were seen.
The study surveyed almost 4000 women treated for breast cancer in 2013-2014, identified from the Los Angeles County and Georgia Surveillance, Epidemiology, and End Results registries. Surveys, recurrence score and tumor data were linked, and showed that the majority of women who received a low recurrence score received a recommendation against chemotherapy, while almost all with a high recurrence score received a recommendation for chemotherapy. Women themselves reported being satisfied both with use of the test as well as treatment decisions. Of particular note, the authors write,"Personalized recommendations appear to reduce potential overtreatment with chemotherapy and nearly eliminated socioeconomic disparities in treatment after we controlled for clinical factors. This is a notable benefit of incorporating the RS into breast cancer treatment algorithms."
Other topics this week include Recurrence and Complications After Elective Incisional Hernia Repair in JAMA, and two from NEJM: Pulmonary Embolism in Patients Hospitalized for Syncope and Romosozumab in Postmenopausal Women with Osteoporosis. Until next week, y'all live well.