Breast cancer treatment: More women may avoid chemotherapy thanks to breakthrough research

06 June, 2018, 19:25 | Author: Darrell Lopez
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"The results of our trial suggest that the 21-gene-assay may identify up to 85 percent of women with early breast cancer who can be spared adjuvant chemotherapy, especially those who are older than 50 years of age", the authors wrote in their paper published in the journal The New England Journal of Medicine.

According to the Irish arm's lead investigator, Prof Maccon Keane of University Hospital Galway, this trial result "is a major advance in precision medicine for women with hormone receptor positive node negative breast cancer".

All of the women in the study, called the Trial Assigning Individualized Options for Treatment (Rx), or TAILORx, had their breast tumors analyzed with a molecular test. By continuing the personalized assessment of an individual's cancer recurrence risk, oncologists can more effectively determine specifically-tailored treatments based on that patient's genomic results.

Patients with a recurrence score of up to 10 out of 100 have previously been shown not to benefit from chemotherapy, and instead need only hormone treatment. Previous studies had made clear that women with low scores could skip chemotherapy and those with high scores should get it.

Some of those women have already been skipping chemotherapy based on less rigorous research.

- You think that when a woman gets breast cancer, chemo is the go-to treatment.

The findings only apply to women with specific early stage breast cancers.

A trial of more than 10,000 women with the most common form of early breast cancer found the treatment was unnecessary for many after surgery.

British experts said the study was "exciting" even though it involved just one patient.




The extensive study revealed that approximately 70 percent of women diagnosed with early-stage breast cancer might not benefit from a treatment protocol that includes chemotherapy.

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

Data presented at the world's biggest meeting of cancer doctors and scientists in Chicago shows these women have the same survival rates with or without chemo.

The 21-gene recurrence-score Oncotype Dx assay is one of several commercially available gene expression assays that can offer prognostic insight in hormone-receptor-positive breast cancer.

Chemotherapy is often used after surgery to reduce the chance of breast cancer spreading or coming back.

Judy Perkins from Florida had been given three months to live by her doctors, but two years later there is no sign of cancer in her body. After an average of nine years, 83.3% of those who did not undergo chemotherapy remained cancer-free, compared to 84.3% of those given chemo.

Because of her work as a nurse, she was familiar with chemotherapy's sometimes harsh effects.

More than 1,200 people enrolled in the study, the largest clinical trial to date of pembrolizumab as a stand-alone therapy for lung cancer. Researchers point out that while the treatment could in principle work for many different kinds of cancer, it will not help everyone.

The success of this case has raised hopes that the therapy could also be used to treat advanced ovarian and prostate cancers. And while this finding certainly doesn't eliminate chemotherapy as a viable tool, it very likely means that a huge number of patients will have the opportunity to receive more personally-tailored treatments in the future.

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