What can be the hidden or unintended consequences of uPA/PAI-1, Oncotype or Mammaprint and its applications for different stakeholders?
Authors: Dario Sacchini, Roberta Minacori, Pietro Refolo
Internal reviewers: Petra Schnell-Inderst, Mirella Marlow, Narine Sahakyan
Two points should be highlighted: firstly, from the justice point of view, there are ethical considerations because moving resources into unproven technologies such as these tests, which have a prognostic function (and the link between the test and both distant recurrence and overall survival are not well understood), may affect the access of other breast cancer patients to chemotherapy. Secondly, there may be opportunity costs for other breast cancer patients in terms of lost opportunities to develop other prognostic tests for this other patient group that might prove to be better. These tests could be diverting research resources and expertise away from other tests and treatments that may prove more useful.
Sacchini D et al. Result Card ETH3 In: Sacchini D et al. Ethical analysis In: Jefferson T, Vicari N, Raatz H [eds.]. Prognostic tests for breast cancer recurrence (uPA/PAI-1 [FEMTELLE], MammaPrint, Oncotype DX ) [Core HTA], Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy ; 2013. [cited 3 December 2022]. Available from: http://corehta.info/ViewCover.aspx?id=113