Rapid Health Technology Assessment of Oncotype DX in Patients with Early-Stage Breast Cancer

Introduction: Breast cancer is the most common cancer in women. Patients are treated with chemotherapy initially, and if not chemically treated, the risk of recurrence of the disease increases yearly. Therefore, methods for identifying patients for whom chemotherapy would be most beneficial are very important. The Oncotype DX test is a prognostic assay that predicts the likelihood of breast cancer recurrence as well as the effectiveness of chemotherapy. Because of the novelty and the high cost of this test, the current study aims to determine its effectiveness and economic effects. Methods: This study, based on rapid health technology assessment, explored the effectiveness and economic consequences of Oncotype DX compared with alternative methods in breast cancer patients. PubMed, Scopus, Web of Science, and Cochrane databases were searched, and only studies about the use of the Oncotype DX test in breast cancer were included. Results: The results of the 32 relevant studies showed that the difference in outcomes was negligible across Oncotype DX and other gene expression profiling tests, but these differences were significant compared with standard treatment. Also, Oncotype DX testing would be cost-saving when used for patients under chemotherapy. However, using this test for all patients may not be cost-saving depending on the number of patients who switch from hormone therapy to chemotherapy and vice versa. Conclusion: Although the results of this study are helpful for policymakers and therapists, it is better to make decisions based on the results of effectiveness and cost in Iran.