Adjuvant therapy

[Ampes]

My husband finally got his final path report and his OncoX score is 32. Still has a decision to make about doing chemo . Has anyone else had to make this decision ? Do the benefits of therapy outweigh the side effects And long term issues suffered from chemo ? Thanks !

[NHMike]

I've never heard of this test or scoring system and didn't find it on the web. Is it shorthand for something else or could you provide a description or link for the test?

I think that we're more used to Staging here with Stage III almost always doing Adjuvant. Stage II is the gray area.

[susie0915]

I've never heard of this score either. I was stage 2A with rectal cancer, and both my surgeon and oncologist recommended adjuvant therapy. Both mentioned even though chance of recurrence was low, don't want to wonder "what if" if I did have a recurrence and didn't do the chemo. There are some on this forum that didn't have adjuvant chemo either because it wasn't offered or chose not to and did have a recurrence and do wonder "what if". It for sure is a hard decision to make. I had 6 rounds of xelox and though not always easy I don't have regrets.

[Beckster]

My husband finally got his final path report and his OncoX score is 32. Still has a decision to make about doing chemo . Has anyone else had to make this decision ? Do the benefits of therapy outweigh the side effects And long term issues suffered from chemo ? Thanks !

Yes, I have heard of this score... <30 (low risk) >30 (intermediate risk) >41 (high risk)

Your husband is like me...intermediate risk. I had stage 2A cancer of the cecum and had a choice for chemo. I opted to take the chemo after discussion with my oncologist from MD Anderson. He felt that the benefits of therapy would be justified for me. He said that if I were his mother, he would tell her to take it. I was on Xeloda (oral form of 5/FU) for 6 months. 8 cycles total. Research also shows that it is recommended for intermediate risk. Xeloda was doable... a little fatigue and hand/foot. After a minute dose adjustment half way through, side effects were much better. I have been off of chemo for 6 months with no side effects.

I would rather be safe than sorry and wonder "what if". I am sure that you will make the correct decision.

[O Stoma Mia]

My husband finally got his final path report and his OncoX score is 32. Still has a decision to make about doing chemo . Has anyone else had to make this decision ? Do the benefits of therapy outweigh the side effects And long term issues suffered from chemo ? Thanks !

Yes, member Fred.R and many others have used this test.

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=43784&p=312798#p312798

[susie0915]

My husband finally got his final path report and his OncoX score is 32. Still has a decision to make about doing chemo . Has anyone else had to make this decision ? Do the benefits of therapy outweigh the side effects And long term issues suffered from chemo ? Thanks !

Yes, member Fred.R and many others have used this test.

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=43784&p=312798#p312798

This is not applicable to rectal cancer right?

[Ampes]

Thanks for the reply’s and the link to the other answers from Fred . We are waiting to talk with the oncologist on the 13 th more in depth . I really think it depends on what type of chemo and how long he recommends he take it if he will decide to take it or not. Chemo as we k ow is not without risk . I will be more anxious if he doesn’t opt for it but ultimately it’s his body and he has to decide. It is such an emotional roller coaster ! Thanks for all of the reply’s ! I’ll let you know what he decides

[O Stoma Mia]

This is not applicable to rectal cancer right?

Yes, I think you are right. In the 2009 ASCO study on Oncotype DX for colon cancer (Kerr, et al), they excluded 707 Rectal Cancer and Stage III patients from the analysis. So it looks like the original results are only applicable to Stage II colon cancer patients.
http://studyres.com/doc/4454991/asco_2009_files-kerr-oncotype-colon-quasar-asco-2009
.
EDIT
However, there is a later 2014 study that expanded the test of this assay to Stage II and Stage III rectal cancer patients, with some positive results.

http://www.ncbi.nlm.nih.gov/pubmed/25261968

Even though NCCN mentions this test in their Rectal Cancer guidelines, they are not too enthusiastic about recommending its general use.

[susie0915]

Thanks for the reply’s and the link to the other answers from Fred . We are waiting to talk with the oncologist on the 13 th more in depth . I really think it depends on what type of chemo and how long he recommends he take it if he will decide to take it or not. Chemo as we k ow is not without risk . I will be more anxious if he doesn’t opt for it but ultimately it’s his body and he has to decide. It is such an emotional roller coaster ! Thanks for all of the reply’s ! I’ll let you know what he decides

Good Luck. I know it is a tough decision. Doing xeloda only would be a good option. I handled the xeloda pretty well during pre adjuvant therapy. I was hoping my oncologist would recommend that but she wanted to do the oxi also after surgery. We all have to do what we feel is best for us. I'm sure you and your husband will weigh all the options and risks in order to come to a good decision.

[NHMike]

I went to their website and they note they look at 12 genes in the Tumor biopsy:

Performed on a tumor sample collected during your patient’s resection, the test looks at the activity of 12 genes in the tumor. The results are quantitative, reproducible, and offer an individualized assessment of risk for patients with either anatomic stage II, MMR-P or stage III A/B colon cancers.

http://www.oncotypeiq.com/en-US/colon-c ... t-the-test

Additionally, Genomic Health provides MMR testing using immunohistochemistry (IHC) to detect the protein expression of two MMR genes (MLH1 and MSH2). Used in conjunction with the Colon Recurrence Score test, MMR status offers deeper insight into the risk of recurrence beyond conventional measures.

I believe that this is current standard of care stuff now as this was done on my biopsy without my requesting it. I think that they did IHC testing on three or four things related to MSI.