Oncotype DX Roll Call!

Moody, here are two graphs from a paper that discusses the prognostic value of Oncotype scores.  The graphs are "Figure 2" from this article: J.A. Sparano & S. Paik: "Development of the 21-gene assay and its application in clinical practice and clinical trials."  Journal of Clinical Oncology Vo. 26 No. 5, Feb. 10, 2008; pp.  721-7228. The article and the figure are copyright-protected, with access available only by subscription.

Part A is a plot of the % of patients who had not developed metastatic BC within 10 years after diagnosis (or surgery?), with Oncotype scores grouped into the 3 categories of "low risk", "intermediate risk", and "high risk".

Part B shows the 10-year rate of distant recurrence, with Oncotype scores plotted as a continuous variable instead of in groups.  The little black lines on the horizontal axis represent each individual woman's Oncotype score.  It's obvious that there were many more scores in the "low risk" category than in the "high risk" category, in the study that validated the scoring system.

To find out (roughly) what recurrence risk corresponds to a particular Oncotype score, find the score on the horizontal axis and draw a line from that place up to the blue line.  Then, draw a line from where you are on the blue line, over to the corresponding place on the vertical axis.  This will provide a rough figure--I suspect in the lab at Genomic Health, they plug the numbers into a mathematical formula, which would be more accurate.

otter 

[Edited to add:  All the scores and recurrence risks reported with Oncotype testing assume the woman will be getting 5 years of tamoxifen.  The graphs above are also for women who've taken or are taking tamoxifen.] 

Hey Moodyk13.

Just wanted to let you know I found my copy of my oncotype test and the score of 33 actually equaled a 22% chance of recurrance.  My onc has said 'about 25%,' so that number got stuck in my brain.:-) 

Hello,

This is my first post to the board.  I am so grateful I came across these discussions.  They are so informative and supportive...just what I needed.   My oncotpye score was 29 - 19% recurrence.  I start chemo (TC x 6 cycles) on Jan 2.  

what if I don't have an oncotype score?  how do i know my risk%?  i'm meeting my oncologist tomorrow....will they have risk #'s just based on my tumor size, grade, etc.?

thanks!

 Below I cut and paste from the Oncotype website how the Oncotype reaccurence score is calculated.   You can see the weight given to HER2 and ER/PR.  the other big factor is the proliferation grouping...

21-Gene Panel Used to Calculate Recurrence Score Result

The Oncotype DX assay gene panel was selected from the published literature, a genomics database and experiments based on DNA arrays performed on fresh-frozen tissue. The Recurrence Score result algorithm was derived from 3 studies of breast cancer patients and then was clinically validated in multiple independent studies.

• The Recurrence Score result is calculated from the expression of 16 cancer-related genes and 5 reference genes used to normalize the expression of those cancer genes
• In clinical studies, the 16 cancer genes demonstrated a consistent statistical link to distant breast cancer recurrence, as well as robust predictive power regarding chemotherapy benefit

21-Gene Panel Used to Calculate Recurrence Score Result:
16 cancer genes and
5 reference genes from
3 studies

Moody,

Wonder what regime all we ladies are on? Would you be able to add it to your list; if so, I am doing 6x TAC every 21 days

Linda

Thanks for updating the list; it is interesting to see the scores even though mime is the highest!!!!

Hi - my score was a 22 with a 14% chance of recurrence. At first my oncologist said I'd be fine with just Arimidex (I'm post-menopausal) but then he realized my Fish report never arrived. After it was faxed to his office he immediately changed his recommendation because it came back Her2++++. However, he thought it overkill to put me on the traditional chemo with Herceptin since it can cause heart damage (the A/C chemo) so he put me on 4 months of Navelbine (which is normally used for liver mets) and I continue for the remainder of the year with Herceptin. He said this will reduce my recurrence risk to 7%. I'm hoping for 0% recurrence since I also opted for a mastectomy even though my tumor was only .9cm large. Only time will tell................