Physicians Share How They Use DCISionRT in Clinic

Predicting Radiation Therapy Benefit with DCISionRT

Presented by: Troy Bremer, Ph.D., Chirag Shah, MD and Pat Whitworth, MD, FACS

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Troy Bremer, Ph.D.

  • CSO and Founder of PreludeDx
0:46 Supportive evidence for DCISionRT
2:12 DCISionRT overview and test results
4:30 Validation data highlights
7:30 RT benefit prediction and NNT data highlight
8:14 Reclassification data highlight

Chirag Shah, MD

  • Radiation Oncologist
  • Director of Clinical Research and Associate Professor
  • Department of Radiation Oncology at the Cleveland Clinic
8:54 Introduction
9:07 Managing DCIS and RT role in background studies
12:30 Who needs or doesn’t need RT?
14:07 Changing treatment recommendations
15:51 Applying DCISionRT in my practice
17:11 Cost effectiveness and value
18:39 Case Studies
19:56 Conclusion: Radiation oncologist’s perspectives

Pat Whitworth, MD

  • Breast Surgical Oncology Specialist
  • St. Thomas Health, Ascension
  • Direction of Nashville Breast Center
21:06 Introduction
21:24 Impact of genomic testing in clinical practice, pre-op visit
22:43 Clinical dilemma for DCIS
24:33 DCIS tools to guide patient management, pros/cons
26:54 Surgical margins and guidelines
28:53 Genomic assays for DCIS
30:58 Identifying patients with RT benefit after BCS
31:58 Patient Discussion with DCISionRT Test Report
32:50 Clinical application and case studies
36:58 Conclusion: Surgeon’s perspectives
37:41 Decision impact PREDICT Registry

Q and A with the Panelists

38:50 How to interpret DCISionRT in context of ET?
39:48 Case study recommendation with low DCISionRT
42:10 Role of MSKCC nomogram for DCIS management?
43:40 DCISionRT protocol in own medical practices?
45:35 Role of APBI in DCIS?
46:48 Which patients are indicated for DCISionRT?

The Clinical Impact of Precision Testing
on Your DCIS Patient Management

Presented by: Christy Kesslering, MD, Troy Bremer, Ph.D. and Jim Pellicane, MD

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Troy Bremer, Ph.D.

  • CSO and Founder of PreludeDx
2:00 DCISionRT—Background of Assay, Supporting Evidence/Data, Outcomes

Jim Pellicane, MD

  • Breast Cancer Surgeon
  • Director of Breast Oncology
  • Bon Secours Cancer Institute
15:50 Introduction
16:16 Surgeon’s clinical dilemma to assessing risk in DCIS patients
22:57 Why is ER not a good indicator of risk assessment?
24:13 Why is patient age is no an independent predictor of risk?
25:23 What are side effects of RT, especially for younger patients?
26:20 What are the surgical options and decisions impacted by RT?
27:11 Case Studies
36:00 Personal lessons learned
39:18 What is the impact of hormone therapy on DCISionRT score?

Christy Kesslering, MD

  • Radiation Oncologist, Breast Cancer Specialist
  • Radiation Oncology Consultants
  • Northwester Medicine Radiation Oncology, Warrenville
39:55 Introduction
40:04 Clinical dilemma: Am I seeing all the patients? When do surgeons refer patients to me?
50:04 Why Tumor Grade and RTOG9804 Classification is not always the best indicator of Risk?
51:23 Case Studies
52:15 Clinical Application of DCISionRT testing for DCIS patients
53:08 Why should DCISionRT be ordered for every patient?
55:20 How genomic testing can help guide intensification and de-escalation of RT
56:52 Challenges and solution insights for radiation oncologists to use genomics in DCIS

Q and A with the Panelists

59:22 Why is 0.8 that DCISionRT common score? Answered by Christy
1:00:46 Turn-around-time and Billing. Answered by Dr. Pellicane
1:01:43 How do you build consensus/buy-in within your medical group/colleagues to implement a DCIS protocol between radiation oncologists and surgeons? Answered by Dr. Pellicane and Dr. Kesslering
1:03:20 Why order DCISionRT on all my DCIS patients? Answered by Dr. Kesslering
1:04:28 What are the results and implications of interaction studies between DCISion Score and RT? Answered by Dr. Bremer
105:59 Conclusion

SHARE Cancer Support: DCIS Recurrence and Radiation

Narrator: Dr. Troy Bremer

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