A study presented at the 2023 San Antonio Breast Cancer Symposium offers insights into the cost-effectiveness of four multigene assays employed in early-stage breast cancer treatment. The study points to the Oncotype DX test as the most beneficial in terms of cost savings and improving patient outcomes compared to using clinical-pathological risk alone.

The research team, comprising biologists, geneticists, and health economists, set out to compare the cost-effectiveness of four multigene assays—Oncotype DX test, MammaPrint, EndoPredict, and Prosigna ROR—in early-stage breast cancer treatment. The study’s objective was to assess these tests’ utility in optimizing treatment decisions by complementing traditional clinico-pathological features. The researchers collated data from published studies and used clinical expert opinions to back up their findings.

The study showed that the Oncotype DX test results in the most substantial lifetime cost savings, estimated at -$13,395. It also generates the largest quality-adjusted life years (QALY) gain at 0.25. All four multigene assays represent a cost-effective resource utilization from a societal perspective, leading to either low net lifetime cost or net cost savings with positive QALY gain.

“It is evident that the Oncotype DX test, among the four multigene assays evaluated, leads to the greatest lifetime cost savings and quality-adjusted life years gain when compared to using clinico-pathologic risk alone in decision making,” the authors wrote.

Without minimizing the importance of the other three multigene assays, the study authors noted, “The prediction capacity of the Oncotype DX test to determine chemotherapy benefit led to considerably higher cost savings and improved breast cancer outcomes.”

Beyond the fiscal benefits, the study’s implications for early-stage breast cancer patients’ clinical care are significant. The quality of life enhancements resulting from the employment of multigene assays offer considerable value, particularly considering the potential adverse side effects of chemotherapy usage. The authors recommend the integration of these multigene assays into regular clinical practice to optimize treatment decisions in HR+/HER2- and axillary lymph node-negative early-stage breast cancer patients.

These findings underscore the immense potential of multigene assays, particularly the Oncotype DX test, in cost-effectively managing early-stage breast cancer treatment. 

Berdunov V, Carter G, Russell C, Campbell S, Racz J, Abdou Y. Comparison of the cost-effectiveness of multigene assays for HR+/HER2- node-negative early-stage breast cancer in the US.  Presented at: the 2023 San Antonio Breast Cancer Symposium; December 5-9, 2023; San Antonio, TX, and virtual; Abstract P01-01-10.