Many With Early Breast Cancer May Not Need Chemo

Pearl Mccarthy
June 5, 2018

And the new treatment could begin immediately.

Now, the choice is getting easier for some patients. They represent roughly half of the more than 17,000 new cases of breast cancer diagnosed in Australia every year. "Breast cancer used to be that deadly disease that women were afraid of and they wanted everything done so they can actually survive".

The study was centred on a 21-gene test performed on tumours that has been available for breast cancer patients since the early 2000s.

Aranda added it could save a lot of women pain and money.

The new study, called TAILORx, is a large, randomized trial involving thousands of patients.

All told, about 70 percent of women with this particular cancer - meaning more than 85,000 women a year in the United States - can safely forgo chemotherapy, the experts concluded. It was uncertain whether the benefits of chemotherapy were enough to justify the risks and toxicity. "I spoke to four people about her case, including one of the doctors associated with the Tailorx trial", said Dr Ramesh Sarin, senior consultant surgical oncology at the Indraprastha Apollo Hospitals. Today, she said, she has a "few spots" in her left lung that Rosenberg believes may be scar tissue.

"Our study shows that chemotherapy may be avoided in about 70 percent of these women when its use is guided by the test, thus limiting chemotherapy to the 30 percent who we can predict will benefit from it", said lead researcher Dr Joseph A. Sparano, associate director for clinical research at the Albert Einstein Cancer Center and Montefiore Health System in NY. She had a lumpectomy, followed by a mastectomy, and had a recurrence score of 12 or 13, which put her in the middle range.

This researchers split the middle-scoring group into two randomized subgroups: one treated exclusively with estrogen-blocking hormone therapy, and one with chemo combined with hormone therapy.

Commenting on the findings, Dr Simon Vincent, director of research at Breast Cancer Now, said the research was "world class".

"You can get them to the same place... without side effects and toxicity", he said.

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The researchers reported that for women younger than 50, results were similar to those of patients who had scores of 15 or lower.

"This information really addresses a major unmet medical need to have a very high level of evidence to make potentially life-saving decisions", Sparano says. "It helps direct patients to the right therapy, so that we're treating the right people with the right therapy at the right time".

It is the first time that a patient with late-stage breast cancer has been successfully treated by a form of immunotherapy that uses the patient's own immune cells to find and destroy cancer cells that have formed in the body.

The subset of breast tumours that form the focus of this study are driven by hormones (oestrogen), do not respond to drugs such as trastuzumab (also known as Herceptin - an engineered antibody that targets HER2), and haven't yet spread to the lymph nodes.

Dr. Jennifer Litton at MD Anderson Cancer Center in Houston, agreed, but said: "Risk to one person is not the same thing as risk to another".

"Chemotherapy has saved a tremendous amount of lives, and will continue to do so", Baselga says. Those women would be treated for the disease only using hormone blocking drugs such Tamoxifen.

"It's a great news story".

"What that test does is look at 21 different genes to see if each is turned on or off and then if it is over-expressed or not", Brawley said. Importantly, chemotherapy still showed some benefit in women with higher Oncotype recurrence scores, and in some women under the age of 50.

Oncotype DX, the genetic test, costs about $4,000. Now only about 60 percent of US patients who could potentially benefit from it are taking the gene test, he says.

The trail started in 2006 enrolled more than 10,000 women in the U.S. and five other countries diagnosed with early-stage breast cancer and followed their progress through post-surgery treatment.

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