A gene expression test can help to prevent unnecessary chemotherapy in breast cancer patients, yet its use in the Netherlands remains limited. This is shown by new research from the Netherlands Comprehensive Cancer Centre (IKNL), led by Sabine Siesling, principal investigator at IKNL and professor at the University of Twente. Even after reimbursement was introduced, only about one in three eligible patients receives a test.
Gene expression tests, such as MammaPrint and Oncotype DX, provide doctors with additional information about the risk of metastases in women with early-stage breast cancer. This information supports decision-making on whether chemotherapy is beneficial. About 13 per cent of all breast cancer patients in the Netherlands are eligible for such a test. Based on data from the Dutch Cancer Registry (NKR), IKNL studied the use of these tests in Dutch clinical practice.
Reimbursement increases use, but remains insufficient
Researcher Joyce Meijer, PhD student at the University of Twente and IKNL, analysed the effect of the reimbursement policy on the use of gene expression tests. Before reimbursement, only 9 per cent of eligible patients received a test. Since October 2023, when reimbursement was introduced in the Netherlands, this percentage has increased to 37 per cent. This could mean that in 2024, more than 1,000 eligible women may not have received the test.
Sabine Siesling, principal investigator at IKNL and professor at the University of Twente, leader of this study: "It is good to see that reimbursement clearly stimulates use. But the use of gene expression tests still falls short of what can be expected. About two-thirds of the patients who are eligible for it still do not receive a test. And that's a shame, because this can mean that women receive chemotherapy unnecessarily." The use of the test is still increasing each year; by now, the total percentage will be higher again.
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