Evaluation of variables that may impact the use of Oncotype DX testing

e11002 Background: Cardinal Health Specialty Solutions (CHSS) partners with payers to manage clinical care pathways in oncology and rheumatology. Observations from one such pathway with CareFirst BlueCross Blue Shield revealed that in patients with estrogen receptor-positive early-stage breast cancer (ESBC), there was an underuse of Oncotype DX testing. To better understand physician behavior as it relates to Oncotype DX testing, CHSS examined patterns of Oncotype DX use in a large private practice oncology group with a robust electronic medical record (EMR), Georgia Cancer Specialists (GCS). We aimed to determine the variables that most impacted the use of Oncotype DX testing. Methods: Using the GCS EMR from 2009 to 2011, we retrospectively identified patients diagnosed with ESBC who were eligible for Oncotype DX testing (stage I-II, node-negative, estrogen receptor-positive, HER2-negative). The use of Oncotype DX testing was analyzed by patient age, tumor size, tumor grade, and physician prescribing patterns. Results: Of the 1908 patients identified with ESBC, 788 were eligible for Oncotype DX testing and 288 (37%) underwent testing. In an analysis by age, Oncotype DX was utilized in 34% of patients ≤ 45 years, 49% in patients 46-55 years, 37% in patients 56-65 years, 34% in patients 66-75 years, and 13% in patients > 75 years old. Oncotype DX use was 37% and 36% in patients with tumor sizes 60% of the time. There were no significant differences in patterns of chemotherapy use. Conclusions: Based on this analysis, eligible patients with ESBC between 46-55 years of age, with small and intermediate sized tumors (