Comparative Analysis Of Multigene Assays (Mga) Effects On Chemotherapy (Ct) Deescalation For Women With N0, Er+ Early Stage Breast Cancer (Esbc).

e12519Background: Therapy de-escalation aims to optimize care with less treatment. Available MGAs aid decisions on CT use for women with N0, ER+ ESBC. Comparative analysis of effects on CT de-escalation has yet to be done on 4 common MGAs: EndoPredict (EP), MammaPrint (MMP), Oncotype DX (ODX), and Prosigna (ROR). Methods: Effects of 4 MGAs on outcomes and costs in N0, ER+ ESBC were summarized using a well-validated analytical framework that adheres to joint ISPOR-SMDM Task Force guidelines for Modeling Good Research Practices. Studies assessing MGA effects on CT use were extracted and summarized using meta-analysis regression to adjust for study differences by study year, academic setting, country, tumor size, and grade. The effect of CT by ODX risk group was based on Paik et al (2006), MINDACT for MMP, and EBCTCG meta-analysis for EP and ROR. Costs (2018 USD) were based on a 2M-member US health plan over 10 y and included CT drugs/administration, supportive care, CT-related ED visits and hospitalizations...