Health Care

Thousands of breast cancer patients could be spared chemotherapy

Thousands of breast cancer patients could be spared chemotherapy

"This is a major finding", said Dr Larry Norton, a breast cancer expert at Memorial Sloan Kettering Cancer Centre in NY, who helped organise the government-funded study more than a decade ago. The test, which has been on the market for several years, analyzes the activity of 21 genes to predict a woman's risk of recurrence over 10 years.

These mid-range women were randomly assigned to either receive hormone therapy alone, or hormone therapy and chemotherapy.

"A lot of work needs to be done, but the potential exists for a paradigm shift in cancer therapy - a unique drug for every cancer patient", he said. It looks for a genetic "signature" in a sample of the tumour and gives a score between 0 and 100, which can help to direct treatment decisions.

The study's primary funding came from the US National Institutes of Health (NIH). But this decision is being reviewed.

Oncotype DX, the genetic test, costs about $4,000.

What did the study show?

But the best treatment for those with a score in the middle has been unclear.

(That mouthful refers to three things: that the cancer was found early, that it could bind to certain hormones and that it didn't have the HER2 receptor.) This type of breast cancer is the most common type, according to the researchers.

But prior to the new trial, "there was uncertainty about the best treatment for women with a mid-range score of 11-25", Sparano explained.

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Now we do. This very large, very important study is telling us that people with those intermediate scores have a very good prognosis and that prognosis is not improved by chemotherapy. Rates for freedom from disease recurrence at a distant site were also similar, at 94.5% and 95% for the endocrine therapy and chemoendocrine therapy groups, respectively, as were rates for freedom from disease at a distant or local-regional site (92.2% and 92.9%, respectively) and for overall survival (93.9% vs 93.8%.).

Thousands of women with early-stage breast cancer may be able to skip chemotherapy, according to a new study.

Many women with early-stage breast cancer who would receive chemotherapy under current standards do not actually need it, according to a major global study that is expected to quickly change medical treatment.

"This study gives us information on a very specific group of women with a very specific type of cancer", she said, "but it doesn't tell us chemotherapy is not effective in some cases". "Practically speaking, this means that thousands of women will be able to avoid chemotherapy, with all of its side effects, while still achieving excellent long-term outcomes", said ASCO expert Dr Harold Burstein. Thankfully, the results were extremely successful: the therapy completely wiped out the cancer cells, and two years later, doctors found no traces of cancerous cells inside her. Exploratory analyses did suggest that the addition of chemotherapy was associated with some benefit for women 50 years of age or younger who had a recurrence score of 16 to 25, but not for those whose score 15 or lower.

The immune cells, known as tumour-infiltrating lymphocytes (TILs), were removed from the patient, multiplied under laboratory conditions and injected back into the bloodstream in large numbers.

Until now, chemotherapy was highly recommended with a result greater than 25, and below 10 it was not.

Then, five and nine years later, the researchers checked in on how the women were doing.

She agreed to take part in a clinical trial with the National Cancer Institute to try a new treatment involving immunotherapy.