Reversal of Endorsement of Oncotype Dx to Guide Chemotherapy

This feature is about a DRAFT guidance from the United Kingdom's NICE, an agency which provides assessments and guidance for the UK's National Health Service (NHS).

Per another article on the posture of NICE: "NICE's remit is to consider both clinical and cost-effectiveness in developing its guidance."

It is NOT practice-changing for those in the USA. Our local guidelines continue to include the OncotypeDX test for invasive disease. For example, the latest version of the NCCN guidelines for Breast Cancer (Version 4.2017, dated February 7, 2018) continues to include the test in the appropriate case.

Regarding the scope, the draft guidance from NICE addresses a variety of prognostic tests, not just the Oncotype test:

"The report contains an assessment of various evidence on the use of commercial tumor profiling tests (including Oncotype Dx, as well as Myriad Genetics' EndoPredict, Agendia's MammaPrint, and NanoString Technologies' Prosigna) intended to update a previous guidance on the use of such tools to guide adjuvant chemotherapy decisions in the NHS in England."

None of these tests is endorsed in the draft guidance, per the feature.

With some regularity, NICE recommends against certain tests and drugs that are included in our local consensus guidelines from ASCO and NCCN, and are and continue to be within our local standards of care in the USA.

Even as regards the UK, this draft guidance document has been published for comment, and the comments will be considered before NICE finalizes an updated guidance on these tests.

BarredOwl

[Edit: grammatical only]