On May 29, 2020 Exact Sciences Corp. (NASDAQ: EXAS) reported it is presenting new data at the 2020 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) (ASCO20) Virtual Scientific Program (Press release, Exact Sciences, MAY 29, 2020, View Source [SID1234558663]). These data further demonstrate the clinical value of the Oncotype DX Breast Recurrence Score test and exemplify the research progress made by Exact Sciences’ Mayo Clinic collaboration toward smarter solutions across the cancer continuum.
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Three studies of the Oncotype DX Breast Recurrence Score test presented at ASCO (Free ASCO Whitepaper)20 highlight the value that the Oncotype DX test can provide by personalizing and improving neoadjuvant treatment decisions (i.e., prior to surgery) in women with hormone receptor positive, HER2-negative breast cancer.
The new data at ASCO (Free ASCO Whitepaper)20 add to existing evidence1,2,3 and reinforce the value of the Oncotype DX test in light of recent COVID-19 pandemic recommendations.4,5
"As health systems across the world respond to the COVID-19 pandemic, both cancer screenings and elective surgeries are being postponed," said Dr. Anthony Lucci, professor of Breast Surgical Oncology at MD Anderson Cancer Center. "Based on the new data presented at ASCO (Free ASCO Whitepaper)20, the Oncotype DX test identified women with a low likelihood of responding to neoadjuvant chemotherapy, who may benefit from alternative approaches while awaiting surgery, such as neoadjuvant endocrine therapy at home. This approach could overcome some of the unique challenges we and our patients are currently facing during this public health crisis."
Response to neoadjuvant chemotherapy and the 21-gene Breast Recurrence Score in young women with estrogen receptor-positive early breast cancer
Abstract Number: 514
This study included 76 women treated with neoadjuvant chemotherapy from the Young Women’s Breast Cancer Study, a multi-center prospective group of women diagnosed with breast cancer at age 40 or younger. The Oncotype DX test was performed on tumor specimens from core biopsies obtained from the patients prior to surgery. Results revealed that patients with a higher Recurrence Score result were more likely to achieve a pathologic complete response (pCR; no residual invasive tumor) with chemotherapy.
21-gene Recurrence Score assay as a predictor of pathological response in neoadjuvant chemotherapy administration for ER-positive/HER2-negative early-stage breast cancer
Abstract Number: e12630
Conducted in Spain, this study prospectively analyzed a group of 63 patients who received neoadjuvant chemotherapy after the Oncotype DX test was performed on tumor specimens from core biopsies. The analysis showed a strong correlation between pCR and Recurrence Score result. In particular, the Recurrence Score result was the most significant predictor of pCR when compared to other factors such as Ki67 (a classic prognostic factor), estrogen receptor status, and initial tumor size.
Prediction of response to neoadjuvant hormonal therapy (NAHT) using upfront Oncotype DX Breast Recurrence Score (RS): results from the SAFIA phase III trial
Abstract Number: 594
In this study, the Oncotype DX test was performed prior to surgery and patients with Recurrence Score results 0-30 received neoadjuvant endocrine therapy without chemotherapy. After four months of treatment, data from 142 patients showed that 97% of them had a clinical response or stable disease, suggesting that patients with a Recurrence Score result <31 can be offered neoadjuvant endocrine therapy alone with minimal risk of progression of disease.
Additional Abstracts Highlight Progress in Research and Development
Through a longstanding collaboration, researchers at Exact Sciences and Mayo Clinic continue to identify biomarkers associated with some of the deadliest forms of cancer. Abstracts accepted for presentation at ASCO (Free ASCO Whitepaper)20, including promising results in five different cancer types, are highlighted below.
Algorithm for blood-based panel of methylated DNA and protein markers to detect early-stage hepatocellular carcinoma (HCC) with high specificity
Abstract Number: 4577
A robust algorithm based on novel blood-based biomarkers provided higher sensitivity for early-stage HCC (70%) compared to other available blood-based methods (54% and 52%) and, therefore, could significantly impact HCC clinical management and patient outcomes.
Molecular detection of pancreatic neuroendocrine tumors using methylated DNA markers: discovery and tissue validation
Abstract Number: e16705
Four novel methylated DNA markers accurately discriminated pancreatic neuroendocrine tumors from controls with normal pancreas and buffy coat (≥ 95% accuracy for each marker). These markers also differentiated metastatic pancreatic neuroendocrine tumors from normal pancreas tissue.
Novel methylated DNA markers in plasma detect distant recurrence of colorectal cancer
Abstract Number: 4088
A panel of novel methylated DNA markers in plasma detected distant recurrent colorectal cancer with promising accuracy (96% in liver metastases, 78% in lung metastases, and 57% in peritoneal/nodal metastases). These data are a positive early signal for the clinical utility of methylated DNA markers for non-invasive post-treatment surveillance and treatment monitoring in colorectal cancer.
Methylated DNA markers for plasma detection of ovarian cancer: discovery, validation, and clinical feasibility
Abstract Number: 6072
Whole methylome sequencing, stringent filtering criteria, and biological validation yielded candidate methylated DNA markers for ovarian cancer that performed with promisingly high sensitivity and specificity in plasma (79% sensitivity at 96% specificity). These data indicate that larger plasma-based ovarian cancer methylated DNA marker testing studies are warranted.
Methylated DNA marker panel for metastatic melanoma: discovery and tissue validation
Abstract Number: e22024
A panel of five novel methylated DNA markers assayed on tissue and undetectable in normal buffy coat achieved a very high discrimination between melanoma and benign control tissues (94% for metastatic melanoma and 85% for primary melanoma). This panel can be assessed in blood or other bodily fluids for application in melanoma surveillance.
ASCO20 will be conducted May 29-31, 2020.
About Oncotype DX
The Oncotype DX portfolio of breast, colon and prostate cancer tests applies advanced genomic science to reveal the unique biology of a tumor in order to optimize cancer treatment decisions. In breast cancer, the Oncotype DX Breast Recurrence Score test is the only test that has been shown to predict the likelihood of chemotherapy benefit as well as recurrence in invasive breast cancer. Additionally, the Oncotype DX Breast DCIS Score test predicts the likelihood of recurrence in a pre-invasive form of breast cancer called DCIS. In prostate cancer, the Oncotype DX Genomic Prostate Score test predicts disease aggressiveness and further clarifies the current and future risk of the cancer prior to treatment intervention, and the Oncotype DX AR-V7 Nucleus Detect test helps determine which patients with metastatic castration-resistant prostate cancer (mCRPC) are resistant to androgen receptor (AR)-targeted therapies. The Oncotype DX AR-V7 Nucleus Detect test is performed by Epic Sciences at its centralized, CLIA-certified laboratory in San Diego and offered exclusively by Exact Sciences. With more than 1 million patients tested in more than 90 countries, the Oncotype DX tests have redefined personalized medicine by making genomics a critical part of cancer diagnosis and treatment. To learn more about Oncotype DX tests, visit www.OncotypeIQ.com, www.MyBreastCancerTreatment.org or www.MyProstateCancerTreatment.org.