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Gene-Expression Profiling Raises Costs for Cancer Care without Improving Outcomes for Low-Risk Breast Cancer Patients, According to Researchers

(NCCN) Jan 23, 2019 - Researchers from Yale School of Public Health find that genetic profiling for cancer tumors is cost-effective for high- and medium-risk patients with breast cancer, but is unlikely to make a meaningful impact on treatment for low-risk patients. New research in the January 2019 issue of JNCCN—Journal of the National Comprehensive Cancer Network reports that using Oncotype DX (ODX)—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not cost-effective for people with breast cancer who are otherwise at low-risk of recurrence. Multigene assays to obtain a gene-expression profile are laboratory tests used to identify the function of specific genes in cancer cells.

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Tomasz M. Beer, MD, FACP (Posted: January 23, 2019)

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This is an excellent reminder that genomic testing is fundamentally no different from any other diagnostic intervention. The context of use matters and the authors should be applauded for their work confirming that in low risk patients, this assays should not be used. The speed with which knowledge is growing in this area will challenge us to frequently reassess the value of emerging diagnostics. New development may alter the value balance. But along the way, clinicians should embrace novel diagnostics when they make a valuable contribution and avoid them when they don't.

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Tomasz M. Beer, MD, FACP

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