ILC, Oncotype and treatment decisions

Lojo
Lojo Member Posts: 303
edited September 2015 in ILC (Invasive Lobular Carcinoma)

http://onlinelibrary.wiley.com/doi/10.1111/tbj.124...

New study on ILC, Oncotype scores and treatment decisions. Interesting article, which points out the need for long term evaluation of whether Oncotype recurrence scores are valid for ILC.


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  • JohnSmith
    JohnSmith Member Posts: 651
    edited August 2015

    In 2011, an ASCO abstract was published called: "Results of Oncotype DX in early-stage invasive lobular carcinoma".
    This has been a topic that has come up from time to time, but doesn't seem to get enough traction that catalyzes a large sweeping study.

    This recent study from Aug 2015 doesn't reveal much in the Abstract. The full article requires payment. Ugh... Assuming you have full access, can you summarize it?

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  • Meow13
    Meow13 Member Posts: 4,859
    edited August 2015

    Well this is interesting one of my tumors was ilc and one idc. I received only one oncodx of 34. My mo strongly recommended chemo but you know I just wasn't willing to do it. I wanted my general health and immune system intact. So far almost 4 years out no reoccurrence knock on wood. Thinking of ditching exemestane too.

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  • treelilac
    treelilac Member Posts: 245
    edited August 2015

    The "juicy" part basically is all in the abstract. The Discussion only said "This study demonstrates that Oncotype Dx testing currently plays a significant role in treatment planning for patients with ILC at our institution." So regardless of the tumors being ILC, the doctors still trusted Oncotype in their decision-making (but only in this institution). It also said since they only followed the patients for 47 months, this was obviously a limitation. "Ultimately, the role of Oncotype Dx RS in the management of patients with ILC will only be definitively established by a study which involves patient outcome analysis in terms of RS subgroup at a minimum of 10 years of follow-up." It stated more answers should come from studies like TAILORx trial to decide on the IR group. The rest (HR, LR groups), we knew.

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  • Lojo
    Lojo Member Posts: 303
    edited August 2015

    Thanks Treelilac - that's basically my conclusion too - that at the authors' institution the Oncotype was being used to guide treatment decisions, but that the real meat of the paper was a call for more rigorous evaluation of Oncotype scores in terms of ILC recurrence rates. I've been following these developments closely, as I relied on the Oncotype score to determine my need/lack of need for chemo. My onc was saying no chemo even before the Oncotype came back because of the traditional diagnostic factors, including mitotic score, but the low number did make me feel more confident in the decision. The other interesting bit from the paper was that the classical ILC morphology was almost all low/medium risk, while the pleomorphic ILC type was more likely to be medium/high risk as determined by Oncotype scores (all of the high risk tumors were pleomorphic, but not all pleomorphic were high risk).

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  • worried15
    worried15 Member Posts: 8
    edited September 2015

    Meow13,

    I too did not do the chemo. I had an oncotype score of 9 low risk. But 2 positive nodes. My cancer was not agreesive very small. I am taking the drug letrzole.

    I am now 1 and 1/2 years out. Just sometimes worry with the 2 positive nodes. My onc. dr gave me the option to not do the chemo. He said the chemo could possibly up the chances of the cancer not coming back by 1.5%. I did no think chemo was worth it.



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  • hlya
    hlya Member Posts: 484
    edited September 2015

    Thanks for the summary. I could only read the 1st page and couldn't see the rest pages.

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