Evidence map›Paper›PMID 23974828›Full record

SynthesisBreast cancer research and treatment2013

The impact of the Oncotype Dx breast cancer assay in clinical practice: a systematic review and meta-analysis.

Josh J Carlson, Joshua A Roth

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Breast cancer research and treatment, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 114 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
114citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

114 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Review
  8. Review
  9. Article
  10. Long-term Survivors of Anaplastic Thyroid Cancer: A Genomic Predictive Model.The Journal of clinical endocrinology and metabolism · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Disparities in OncotypeDx Testing and Subsequent Chemotherapy Receipt by Geography and Socioeconomic Status.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024
    Article
  17. Article
  18. Review
  19. Article
  20. Article

54 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

2 authors.

Josh J CarlsonPharmaceutical Outcomes Research and Policy Program, University of Washington, 1959 NE Pacific Ave, Box 357630, Seattle, WA 98195-7630, USA. carlsojj@uw.edu
Joshua A Roth

Funding

UW Centers for Comparative and Health Systems Effectiveness Training ProgramK12HS019482 · AHRQ · UNIVERSITY OF WASHINGTON · PI SULLIVAN, SEAN D · 2010 to 2010
$1.6M
Health Care Improvement for Aging WomenT32AG027677 · NIA · KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · PI LACROIX, ANDREA Z. · 2007 to 2016
$1.4M
AHRQ HHS K12 HS019482NIA NIH HHS T32 AG027677
6 · The paper itself

Abstract

The impact of the Oncotype Dx (ODX) breast cancer assay on adjuvant chemotherapy (ACT) treatment decisions has been evaluated in many previous studies. However, it can be difficult to interpret the collective findings, which were conducted in diverse settings with limited sample sizes. We conducted a systematic review and meta-analysis to synthesize the results and provide insights about ODX utility. Studies, identified from PubMed, Embase, ASCO, and SABCS, were included if patients had ER+, node -, early-stage breast cancer, reported use of ODX to inform actual ACT decisions. Information was summarized and pooled according to: (1) distribution of ODX recurrence scores (RS), (2) impact of ODX on ACT recommendations, (3) impact of ODX on ACT use, and (4) proportion of patients following the treatment suggested by the ODX RS. A total of 23 studies met inclusion criteria. The distribution of RS categories was 48.8 % low, 39.0 % intermediate, and 12.2 % high (21 studies, 4,156 patients). ODX changed the clinical-pathological ACT recommendation in 33.4 % of patients (8 studies, 1,437 patients). In patients receiving ODX, receipt of ACT were: 28.2 % overall, 5.8 % low, 37.4 % intermediate, and 83.4 % high. Low RS patients were significantly more likely to follow the treatment suggested by ODX versus high RS patients RR: 1.07 (1.01–1.14) [corrected].The pooled results are consistent with most individual studies to date. The increased proportion of intermediate scores relative to original estimates may have implications for the clinical utility and cost impacts of testing. In addition, low versus high RS patients were significantly more likely to follow the ODX results, suggesting a tendency toward less aggressive treatment, despite a high ODX RS. Finally, there was a lack of studies on the impact of ODX on ACT use versus standard approaches, suggesting that additional studies are warranted.

Indexed as

Chemotherapy, AdjuvantPatient SelectionAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsCombined Modality TherapyConfounding Factors, EpidemiologicDatabases, FactualEstrogensFemaleGene Expression ProfilingGenes, NeoplasmHumansNeoplasm MetastasisNeoplasm ProteinsNeoplasm Recurrence, LocalNeoplasms, Hormone-DependentEstrogensNeoplasm ProteinsReceptors, Estrogen

Identifiers

PMID23974828
PMCPMC3902996

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.