What is the Oncotype DX® test for Colon Cancer?

• When Should The Oncotype DX Test Be Used?

Overview


The Oncotype DX Colon Cancer Assay is a new, gene-based diagnostic test that can help men and women with some types of colon cancer learn more about the biological features of their specific tumor and help indicate how likely it is that a patient’s colon cancer may return in the future (recurrence). Coupled with other pieces of information, the results from the Oncotype DX test can help patients and their doctors make personalized decisions about whether or not to include chemotherapy for colon cancer in their treatment plan.

One of the challenges in treating patients with colon cancer is determining the risk that the disease will return after surgery, and justifying the need for additional post-surgical chemotherapy. Post-surgical chemotherapy is given with the intent to further diminish the chance of colon cancer coming back. The estimation of the chance of colon cancer coming back (risk of cancer recurrence) is one of many important factors to consider in deciding whether a patient with Stage II colon cancer should or should not get chemotherapy after surgery. Oncotype DX provides a new way for assessing the risk of recurrence in Stage II colon cancer, and improves the ability to make an informed and personalized decision for each patient.

The Oncotype DX test evaluates a select 12-gene set taken from an individual’s colon cancer sample - 7 colon cancer genes and 5 reference genes - to see how they are expressed, or how active they are. The results of the test are reported as a quantitative Recurrence Score® result, which is a score between 0 and 100 that correlates with the likelihood of a person’s chances of having the colon cancer return. The report may also provide your MMR status which may help you and your doctor in making treatment decisions. Studies have shown that stage II colon cancer patients with MMR-deficient (MMR-D) tumors have a lower risk of recurrence compared to patients with MMR-proficient (MMR-P) tumors.

The Oncotype DX colon cancer test arms the physician with an additional tool in evaluating the needs of the individual colon cancer patient in addition to looking at the individual’s clinical and pathologic characteristics, so that the physician and the patient are in a better position to make the best individualized colon cancer treatment decision.

When Should the Oncotype DX Test Be Used?

The Oncotype DX test should be performed after surgery (resection), but before you and your doctor make a final decision regarding adjuvant chemotherapy treatment (see figure below).

The Oncotype DX test is a non-invasive test that is performed on a small amount of the tissue removed during your original colon cancer surgery or biopsy. This means you should not have to undergo any additional invasive procedures for the test to be performed.

After your surgical procedure, a tissue sample is preserved for further diagnostic testing. If the Oncotype DX test is ordered, the pathologist will send several thin sections of the preserved tumor tissue sample to Genomic Health. The Oncotype DX test results are then integrated with other laboratory test results to help you and your doctor formulate a colon cancer treatment plan based on the unique characteristics of your tumor.


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