Oncotype vs. MammaPrint (Symphony)

JohnSmith

Most know that Oncotype is the standard diagnostic test in the U.S. to determine recurrence risk and worthiness of chemo for a subset of patients.

Here's a quick breakdown of the companies that make genomic assays. For those that want a second opinion on their Oncotype score (especially when they fall into that vague middle score range), it might be wise to ask your oncologist if they can try these other tests.

1. Oncotype, OncotypeDX (21 genes), by publicly traded [Ticker: GHDX], Genomic Health Inc. www.genomichealth.com

2. Prosigna, PAM50 (50 genes) by publicly traded [Ticker: NSTG], NanoString Technologies. www.prosigna.com

PAM50 is indicated for use in postmenopausal women with ER+, node-negative (Stage I or II), or node-positive (Stage II) breast cancer to be treated with adjuvant endocrine therapy.

3. MammaPrint (Symphony), MammaPrint (70 genes), Mammostrat (5 genes) by privately held, Agendia. www.agendia.com

4. BCI (Breast Cancer Index), by BioTheranostics, part of French owned bioMerieux group, www.biotheranostics.com [Note: BCI was granted Medicare coverage in October 2014, although as of May 2015, BCI has not been cleared or approved by the FDA yet]

January 2016 update:
San Diego-based bioTheranostics, which has operated since 2008 as a division of the French diagnostics conglomerate bioMerieux, secured $32 million in financing to commercialize its diagnostic cancer tests and expand its clinical development programs.
The financing will enable bioTheranostics to operate as an independent company, following its spin out from bioMérieux, which will retain a minority stake. It was unclear how much control bioTheranostics had over its own fate, or whether bioMerieux was essentially spinning out a business unit it had operated for the past eight years.
BioTheranostics had its origins as AviaraDx, a Carlsbad, CA-based startup specializing in molecular diagnostic technologies. BioMérieux acquired it for $60 million in 2008.

5. OncoMasTR by OncoMark (oncomark.com). OncoMark Ltd is an Irish diagnostics company founded by Prof William Gallagher and Steve Penney. OncoMasTR is a novel multi-gene prognostic assay for early stage (ER+, Lymph-node negative) breast cancer patients and will determine the risk of recurrence. It uses transcriptional networks and outperforms currently used tests like Oncotype DX. It may be useful for TNBC and ILC patients.

Which test have you done?

August 2014 Update: For those that live in Australia, it was just
announced by NanoString that they received market approval
(by the TGA) to market the Prosigna Assay.

voraciousreader

John....the simple answer is that the OncotypeDX has been incorporated into the NCCN breast cancer treatment guidelines since 2011, so it has been used longer than Mammaprint.  That said, it seems if after receiving an OncotypeDX in the intermediate range, then some physicians are turning to the Mammaprint test.  Mammaprint has yet to be incorporated into the NCCN guidelines despite looking at more genes.

barcelonagirl

Hi John! I had both tests run.  The ODX came back in the intermediate area with a score of 21, and we didn't know what to do.  After 2nd and 3rd opinions (many of which said chemo would probably not benefit me), it was suggested they run a MammaPrint test.  Despite all the positive indications that I wouldn't need chemo, (small grade 1 tumors, no nodes, low intermediate ODX score) my test came back high risk for recurrence.  I went through with the chemo.  While MammaPrint is a newer test, I felt very comfortable relying on the results.  It is FDA cleared, looks at more genes, results based on 10 yr data (I got that from their brochure) and provides a definitive "yes" or "no" result.  If I had it to do again, and knowing what I now know,  I would have asked for the MammaPrint/BluePrint up front!!

SpecialK

Oncotype Dx is only available for ER+ and Her2-, and many MO will not submit samples for node positive patients, although some will for 1-3 positive nodes. Mammaprint can be used for any hormonal receptor combination, but usually comes back as high risk if the sample is Her2+. I had this testing done because my surgeon was working on a project with Agendia labs, but my insurance denied payment even though FDA approved, they considered the testing "experimental" in nature.

JohnSmith

Has anyone else done diagnostic tests that were not Oncotype?

If so, which test have you done?

What were the results?

voraciousreader

John...some patients have had Mammaprint. Also...come back to the San Antonio thread....I posted a development on Mammaprint... It seems like every month, there is a new test on the horizon...

Anonymous

Love this discussion.  JohnSmith, thanks so much for the info!