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How are you using predictive tests such as DCISionRT (PreludeDx) or OncotypeDX DCIS in the management of DCIS?

What advantages/disadvantages are there between assays or over traditional clinical pathologic factors? What other concerns do you have? For additional reading, see JCO OGR 11/2021 by @Dr. First Last and @Dr. First Last reviewing landscape of adjuvant treatment after lumpectomy for DCIS, and companion study with longterm outcomes from RTOG 9804 (@Dr. First Last et al).
4 Answers
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Radiation Oncology · USC Keck School of Medicine
Answered on · Updated on

Advantages:

  • It's a relatively cheap, simple assay to better individualize risk of DCIS.
  • Not only prognostic like Oncotype DCIS but also predictive of the absolute benefit of radiation.
  • Supposed to be a better risk assessment tool than traditional clinical pathologic factors.
  • Can identify those who ...

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Radiation Oncology · Ohio State University
Answered on

The DCISionRT seems to have overtaken Oncotype DX for DCIS in terms of predictive ability, in addition to providing a group of patients in whom one can safely omit RT. Even in patients identified with Oncotype as "low risk", ipsilateral failure rates are around 13%, with invasive recurrences around ...

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Radiation Oncology · Memorial Sloan Kettering Cancer Center
Answered on

At Memorial Sloan Kettering, where I work, we have 10 dedicated breast pathologists who read all of the breast slides and meet weekly to discuss any “difficult” cases. With this resource, I never order a test like Oncotype DX, because I am very confident in the pathologists’ ability to define “good ...

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Radiation Oncology · Dana-Farber Cancer Institute
Answered on

At the current time at our institution, we are only using predictive tests, specifically DCISionRT testing, in the context of the prospective PREDICT trial (NCT03448926). Our goal in doing so is to help collect data to study the prognostic and predictive value and clinical utility of DCISionRT testi...

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