Chemoradiotherapy before surgery may extend lives of pancreatic cancer patients

Pearl Mccarthy
June 8, 2018

Thousands of patients diagnosed with breast cancer could avoid chemotherapy, that's according to the findings of a new study released this past weekend at the American Society of Clinical Oncology Conference in Chicago.

A gene test called "Oncotype DX" has been guiding doctors for years on whether women need chemo if early stage, estrogen-fueled breast cancer that hasn't spread.

Certain women 50 or younger did benefit from chemo; slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test. "This clinical trial is looking at women who have slightly higher risk scores - technically considered to be in the intermediate risk range". Now research on more than 10,000 patients finds those mid-range women can safely be spared chemotherapy without affecting survival rates.

TAILORx, a phase 3 clinical trial, opened in 2006 and was created to provide an evidence-based answer to the question of whether hormone therapy alone is not inferior to hormone therapy plus chemotherapy. Nine years after the treatment was administered, 93.8% were still alive in the chemo group, while 93.9% were still alive in the endocrine-only group.

Those who score high - 26-100 - receive both hormone therapy and chemotherapy. "We know that we can use this data and tell women firmly, 'You don't need chemotherapy; you're going to do so well without it'". More studies are still needed to look at those groups of women.

There is one caveat to the new findings.

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An analysis of a 2015 study of 249 patients found Omega-3 helped relieve symptoms among obese women taking the drug, who are more likely to experience joint pain. However, it is unclear if this benefit is due to the effect of chemotherapy or to endocrine suppression caused by chemotherapy-induced menopause. "The trial was created to address this question and provides a very definitive answer", said Dr. Sparano.

The study published on Sunday, on which early-stage breast cancer patients can forgo chemo, is by far the most impactful so far.

TAILORx was one of the first large-scale trials to examine a methodology for personalizing cancer treatment. In addition, these early tumors must be sized at five centimeters or less and not invasive to the lymph nodes. The stamp funding provided more than $5 million to the trial.

But some of the more striking developments unveiled in the past week involve breast cancer.

The genomic assay used in the trial was the Oncotype DX Breast Recurrence Score test from Genomic Health, Inc., Redwood City, California.

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