Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Predicting 21-Gene Recurrence Score Test Uptake

Clin Breast Cancer; 2017 Nov 29; Hull, et al

Uptake of the 21-gene recurrence score test in patients with node negative, hormone-receptor positive, HER2 negative breast cancer appeared to be influenced by site of care and tumor type, according to a retrospective cohort study involving 328 individuals. Investigators looked at patient and site of care characteristics, and whether these impacted receipt of the 21-gene test in newly-diagnosed participants. Among the results:

  • One-fourth of patients had the 21-gene test.
  • 3 in every 10 sought care at a VA center where no tests were ordered.
  • Patients who received care at a VA center with women’s health services were 84% more likely to receive the test.
  • Those with tumor characteristics meeting the NCCN 2010 test criteria were >3 times more likely to receive the test.
  • Increasing age and fee-based care negatively predicted test uptake.
  • Most tested patients received guideline-based care.


Hull L, Lynch J, Berse B, et al. Clinical impact of the 21-gene recurrence score test within the Veterans Health Administration: Utilization and receipt of guideline-concordant care. [Published online ahead of print November 29, 2017]. Clin Breast Cancer. doi:10.1016/j.clbc.2017.11.018.

This Week's Must Reads

Six factors predict urothelial cancer response, Pond GR et al. GU Cancers Symposium Abstract 413

Combo bests single therapy in metastatic RCC, Motzer RJ et al. GU Cancers Symposium Abstract 578

Chemo is best course in resected urothelial disease, Birtle A et al. Genitourinary Cancers Symposium. Abstract 407.

Selecting chemoradiation in bladder cancer, Coen, J. et al, 2018 Genitourinary Cancers Symposium, Abstract 408.

When to choose surgery or surveillance in RCC, Hakimi A et al. J Urol. 2018 Feb 26 doi: 10.1016/j.juro.2018.02.3087.

Must Reads in Breast Cancer

FDA Approves Lynparza for Certain Types of BC, FDA news release; 2018 Jan 12

Stereotactic Radiotherapy System Approved For BC, FDA news release; 2017 Dec 22

Perjeta Approved for Certain Type of Early BC, Genentech news release; 2017 Dec 20

Do Women with BC Use Their Pain Meds Correctly?, J Pain Symptom Manage; ePub 2017 Dec 5; Stephenson, et al

Immediate Breast Reconstruction Likelihood Studied, Clin Breast Cancer; ePub 2017 Dec 6; Reddy, et al