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Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial.

Publication ,  Journal Article
Robertson, SJ; Ibrahim, MFK; Stober, C; Hilton, J; Kos, Z; Mazzarello, S; Ramsay, T; Fergusson, D; Vandermeer, L; Mallick, R; Arnaout, A ...
Published in: J Eval Clin Pract
April 2019

OBJECTIVE: The three Magee Equations provide an estimate of the Oncotype DX recurrence score using commonly available clinicopathologic information (tumour size, grade, oestrogen receptor, progesterone receptor, HER2, and Ki67). We assessed whether integration of Magee Equations into routine clinical practice affected the frequency of Oncotype DX requests. METHODS: Patients with newly diagnosed, node negative, hormone receptor positive, and HER2 negative invasive breast cancer were randomized to undergo a Magee calculation or not. At the first clinic assessment, the oncologist was provided with all routinely available clinicopathologic information (including Ki67) either with or without the results of Magee Equations. Primary outcome was frequency of Oncotype DX ordering. Secondary outcomes included frequency of chemotherapy use, time to commencement of radiotherapy, or systemic therapy. Physician comfort with systemic therapy choices and the use of Ki67 and Magee Equations was also assessed. RESULTS: Data from 175 randomized patients was available, 84 patients (48%) with and 91 (52%) without calculated Magee Equations. Oncotype DX was ordered in 10 (12.05%) and 13 (14.44%) (RR 0.83, 0.39-1.80; P = 0.64) in the Magee and no Magee groups, respectively. There were no statistically or clinically significant differences between the randomized groups for any of the secondary outcomes. Availability of both Ki67 and Magee Equations was associated with increased physician comfort around systemic treatment decisions. CONCLUSIONS: In a practice where Ki67 is routinely available, addition of Magee Equations into routine clinic practice was not associated with a reduction in Oncotype DX use. Availability of both Ki67 and Magee Equations did however increase physician comfort with systemic therapy decisions.

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Published In

J Eval Clin Pract

DOI

EISSN

1365-2753

Publication Date

April 2019

Volume

25

Issue

2

Start / End Page

196 / 204

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Prospective Studies
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Medical Oncology
  • Humans
  • Health Policy & Services
  • Diagnostic Tests, Routine
  • Clinical Decision-Making
  • Breast Neoplasms
 

Citation

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Robertson, S. J., Ibrahim, M. F. K., Stober, C., Hilton, J., Kos, Z., Mazzarello, S., … Clemons, M. (2019). Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial. J Eval Clin Pract, 25(2), 196–204. https://doi.org/10.1111/jep.13094
Robertson, Susan J., Mohammed F. K. Ibrahim, Carol Stober, John Hilton, Zuzana Kos, Sasha Mazzarello, Tim Ramsay, et al. “Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial.J Eval Clin Pract 25, no. 2 (April 2019): 196–204. https://doi.org/10.1111/jep.13094.
Robertson SJ, Ibrahim MFK, Stober C, Hilton J, Kos Z, Mazzarello S, et al. Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial. J Eval Clin Pract. 2019 Apr;25(2):196–204.
Robertson, Susan J., et al. “Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial.J Eval Clin Pract, vol. 25, no. 2, Apr. 2019, pp. 196–204. Pubmed, doi:10.1111/jep.13094.
Robertson SJ, Ibrahim MFK, Stober C, Hilton J, Kos Z, Mazzarello S, Ramsay T, Fergusson D, Vandermeer L, Mallick R, Arnaout A, Dent SF, Segal R, Sehdev S, Gertler S, Hutton B, Clemons M. Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial. J Eval Clin Pract. 2019 Apr;25(2):196–204.
Journal cover image

Published In

J Eval Clin Pract

DOI

EISSN

1365-2753

Publication Date

April 2019

Volume

25

Issue

2

Start / End Page

196 / 204

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Prospective Studies
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Medical Oncology
  • Humans
  • Health Policy & Services
  • Diagnostic Tests, Routine
  • Clinical Decision-Making
  • Breast Neoplasms