Evaluates cost-effectiveness of recurrence score in early-stage breast cancer, suggesting improved decision-making and reduced unnecessary treatments.
The aim of this study is to re-evaluate the decision of adjuvant chemotherapy according to TAILORx trial in our patients included in the prospective clinical study based on NSABP-20 criteria, and to recalculate the cost-effectiveness of ODX RS. Patients were analyzed for cost-effectiveness in the chemotherapy + endocrine therapy or endocrine therapy. The cost-effectiveness analyses of treatment before and after the ODX RS ® result were compared according to Tailor X. The deterioration in quality of life during chemotherapy was calculated based on the time the patient was away from daily activities, 6 months of work loss in 1 year and the cost of chemotherapy. ICER (ICER: Incremental Cost-Effectiveness Ratio) was calculated for cost-effectiveness. During a median follow-up period of 108.4 months (range 15.8–111), in 11 (6.7%) patients metastases were detected. Three patients (1.8%) died due to breast cancer. Among 92 patients who were scheduled for chemotherapy (CT) before the RS ® results were available, 41 were genomically low-risk and based on this findings were omitted from chemotherapy. According to the first study in which the chemotherapy decision was based on NSABP-20 18 patients (~ 20%) received unnecessary chemotherapy with the updated Tailor X criteria. Compared to a purely clinico-pathological assesment, a treatment based on ODX RS ® was found to be at least $1938 more cost-effective (0.68 QALYs). In conclusion, the Oncotype DX Recurrence Score (ODX RS ® ) test in Turkey was found to be cost-effective in HR(+) HER2(-) patients according to the updated TAILORx data for adjuvant chemotherapy decisions. Not applicable.
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