Taking into account the costs of five commonly used chemotherapy regimens, the use of empiric chemotherapy in such patients costs an average of $12,923 per year of life gained, compared with $5,124 per year of life gained with the use of a strategy of selective chemotherapy guided by the Oncotype DX score. The potential savings through routine use of the 21-gene assay were greatest among patients at least 50 years of age, for whom empiric chemotherapy cost an average of $28,742 per year of life gained, compared with $16,108 using a selective strategy of Oncotype DX-guided chemotherapy, according to Dr. Lyman of the University of Rochester (N.Y.).
He added that his figures understate the test's true value because they don't factor in the quality-of-life issues that further enhance the attractiveness of a test that safely enables many patients to avoid chemotherapy. Patients dread the toxicities of chemotherapy, including nausea and vomiting, hair loss, profound fatigue, and infections. His study was funded by Genomic Health, as was the Kaiser epidemiologic study.
Future projects will include tweaking the 21-gene assay so it can be applied to patients with node-positive breast cancer, and research on the value of chemotherapy in patients with an intermediate score on the Oncotype DX.