{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T16:04:26Z","timestamp":1791129866130,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2012,2,22]],"date-time":"2012-02-22T00:00:00Z","timestamp":1329868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2012,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Gene expression profiling (GEP) is being used increasingly for risk stratification to identify women with lymph node\u2010negative, estrogen receptor\u2010positive, early stage breast cancer who are most likely to benefit from adjuvant chemotherapy. The authors of this report evaluated the cost effectiveness of recurrence score\u2010guided treatment using 2 commercially available GEP tests, Onco<jats:italic>type<\/jats:italic> DX (Genomic Health, Redwood City, Calif) and MammaPrint (Agendia Inc., Irvine, Calif), from a third\u2010party payer's perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>A 10\u2010year Markov model was developed to compare the costs and quality\u2010adjusted life\u2010years (QALYs) of treatment decisions guided by either Onco<jats:italic>type<\/jats:italic> DX or MammaPrint in a hypothetical cohort of women with early stage, lymph node\u2010negative, estrogen receptor\u2010positive breast cancer who may experience recurrence. Outcomes included no recurrence, recurrence, and death. The costs considered included gene test costs, the costs of adjuvant chemotherapy and other chemotherapy (including premedication, oncology visits, and monitoring for adverse events), the cost of treating recurrence, costs associated with the treatment of adverse events, and end\u2010of\u2010life care costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>The model demonstrated that the patients who received the Onco<jats:italic>type<\/jats:italic> DX test to guide treatment spent $27,882 (in US dollars) and gained 7.364 QALYs, whereas patients who received the MammaPrint test to guide treatment spent $21,598 and gained 7.461 QALYs. Sensitivity analyses demonstrated that the results were robust to changes in all parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>The model suggested that MammaPrint is a more cost\u2010effective GEP test compared with Onco<jats:italic>type<\/jats:italic> DX at a threshold willingness\u2010to\u2010pay of $50,000 per QALY. Because Oncot<jats:italic>ype<\/jats:italic> DX is the most frequently used GEP in clinical practice in the United States, the authors concluded that the current findings have implications for health policy, particularly health insurance reimbursement decisions. Cancer 2012. \u00a9 2012 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.27443","type":"journal-article","created":{"date-parts":[[2012,2,22]],"date-time":"2012-02-22T12:44:09Z","timestamp":1329914649000},"page":"5163-5170","source":"Crossref","is-referenced-by-count":63,"title":["Cost effectiveness of gene expression profiling for early stage breast cancer"],"prefix":"10.1002","volume":"118","author":[{"given":"Mo","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suja","family":"Rajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia M.","family":"Issa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,2,22]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20073"},{"key":"e_1_2_6_3_2","unstructured":"National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Breast Cancer. Version 2.2011 March 2011 update. Available from:http:\/\/www.nccn.org\/professionals\/physician_gls\/PDF\/breast.pdf. Accessed on November 18 2011"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc091265"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1200\/JCO.1995.13.6.1459","article-title":"Appropriateness of adjuvant systemic therapy for axillary node\u2010negative breast cancer: a physician opinion survey","volume":"13","author":"Sawka CA","year":"1995","journal-title":"J Clin Oncol."},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2003.0017"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200106283442607"},{"key":"e_1_2_6_8_2","unstructured":"National Cancer Institute. Phase III randomized study of adjuvant combination chemotherapy and hormonal therapy versus adjuvant hormonal therapy alone in women with previously resected axillary node\u2010negative breast cancer with various levels of risk for recurrence (TAILORx trial). October 2010 update. Available from:http:\/\/www.cancer.gov\/clinicaltrials\/ECOG\u2010PACCT\u20101. Accessed on November 18 2011"},{"key":"e_1_2_6_9_2","unstructured":"National Cancer Institute. The TAILORx breast cancer trial. October 2010 update. Available from:http:\/\/www.nci.nih.gov\/clinicaltrials\/digestpage\/TAILORx. Accessed on November 18 2011."},{"key":"e_1_2_6_10_2","unstructured":"European Organization for Research and Treatment of Breast Cancer. MINDACT (Microarray In Node\u2010negative and 1 to 3 positive lymph node Disease may Avoid ChemoTherapy): a prospective randomized study comparing the 70\u2010gene signature with the common clinical\u2010pathological criteria in selecting patients for adjuvant chemotherapy in breast cancer with 0\u20103 positive nodes. October 2010 update. Available from:http:\/\/www.eortc.be\/services\/unit\/mindact\/MINDACT_websiteii.asp. 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