Abstract P5-08-30: Utilization of oncotype DX for breast cancer in different facility types in Louisiana

Abstract

Abstract Background: Oncotype DX, a 21-gene recurrence score, is the most validated prognostic assay that may identify both women most and least likely to benefit from adjuvant chemotherapy. It was added to the ASCO guidelines in 2007 and the NCCN guidelines in 2008 for use in node negative, hormone receptor (HR)+, HER2- breast cancer patients who will undergo 5 years of endocrine therapy. We explored its utilization in different cancer care settings to assess differences in the tool's utilization. Methods: We analyzed data from the Louisiana Tumor Registry, one of the NCI funded SEER registries for cases of HR+ HER2- localized breast cancer from 2010-2012 and explored differences in utilization of the Oncotype DX by facility type – teaching hospital cancer program (THCP), community hospital comprehensive cancer program (COMP), community hospital cancer program (CHCP), commission on cancer program (COC) and public hospital program. Chemotherapy administration data was collected on the 2011 cases with chemotherapy data collected from a CDC funded special project Enhancing Cancer Registry Data for Comparative Effectiveness Research (CER). Hospital sites were identified by the location where patients underwent surgery. Demographic and clinical factors were adjusted for using multivariate logistic regression. Results: Of the patients who did have the Oncotype DX, 39.2% were white, 32.3% black. Women over 70 were much less likely (29.3% vs. >45% in women <70) to have the test. Patients who received surgery at public hospitals had the lowest chance (16.7%), whereas those who received surgery at COMP were most likely to have the test (43.1%) and at teaching hospitals, 31.8% had the test. The odds of not using Oncotype DX were significantly higher in public hospitals than THCP even after adjusting for demographic and clinical factors (OR=2.44; 95% CI: 1.39-4.27). Odds Ratios and 95% CIs for Oncotype DX (No/Yes) in HR+/HER2- localized breast cancer in 2010-2012, LouisianaHospital type#Crude Odds Ratio and 95% CIAdjusted Odds Ratio and 95% CITHCP422referencereferenceCOMP4891.63 (1.24-2.14)0.56 (0.41-0.76)CHCP8101.35 (1.06-1.74)0.74 (0.56-0.98)Public1140.43 (0.25-0.73)2.44 (1.39-4.27)NonCOC/Non Public10321.37 (1.07-1.74)0.70 (0.53-0.92) Conclusions: Patients who had the Oncotype DX performed in our Louisiana database were most likely white, <70 and had their surgeries at COMP. The odds of not having the Oncotype DX performed were significantly higher in public hospitals as compared with teaching hospitals when adjusting for demographic and clinical factors. Citation Format: Loch M, Li X, Mumphrey B, Garcia A, Wu X-C. Utilization of oncotype DX for breast cancer in different facility types in Louisiana [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-08-30.