Behind the Development of the DCISionRT Test in DCIS

Chirag Shah, MD, radiation oncologist at Cleveland Clinic, co director of the comprehensive breast cancer program, and director of breast radiation oncology, discusses the challenges in predicting the risk of local recurrence in patients with ductal carcinoma in situ (DCIS), and what led to the DCISionRT test.

At this year's American Society for Radiation Oncology (ASTRO) Annual Meeting in San Diego, California, Shah presented an analysis of the PREDICT study (NCT03448926). Here, he evaluated the utility of DCISionRT testing on radiation therapy recommendations for patients with DCIS.

Transcription:

0:10 | The PREDICT study is a prospective multi institutional observational registry. What we wanted to understand is what happened when patients had DCISionRT testing in terms of radiation recommendations. The primary end point of the study was to look and see what recommendations were before and after, and to identify the percentage of patients whose testing led to a change in radiation and recommendations after the use of this testing.

0:35 | Radiation therapy for patients with DCIS is a controversial topic. There have been a lot of clinical trials that have shown that radiation in this situation reduces the risk of local recurrence, meaning a cancer coming back in the breast, but it has no impact on survival. For several decades, we have looked to see if we can use traditional factors like patient factors, or factors in the pathology report when they have surgery to identify patients that benefit and do not benefit from radiation therapy.

1:04 | Unfortunately, what we have seen is that these studies still have high rates of recurrence. So what led to the DCISionRT was the idea of, can we use the patient's own tumor, along with some clinical and pathologic features, to identify the patients that do and don't benefit from radiation therapy?