Breast cancer: Test means fewer women will need chemo

Adjust Comment Print

These are the results from a single patient and much larger trials will be needed to confirm the findings. The study was sponsored by the National Cancer Institute and led by the ECOG-ACRIN Cancer Research Group.

"I think everyone will now feel more comfortable with their decisions", Dr. Otis Brawley, MACP, FASCO, FACE, chief medical and scientific officer for the American Cancer Society, told Healthline.

WHEN THIS Delhi-based businesswoman was recently diagnosed with early stage breast cancer, her world came crashing down.

Angela Harris, head of Scotland at Breast Cancer Care, said: "This incredible news is game-changing as it means thousands of women in Scotland and across the United Kingdom will be able to avoid chemotherapy with confidence".

The cancer was at an early stage and had not spread to the lymph nodes.

A high score means chemotherapy could be useful, and a low score less so.

The 49-year-old woman was selected for the radical new therapy after several rounds of routine chemotherapy failed to stop a tumour in her right breast from growing and spreading to her liver and other areas. However, this left the majority of women with the condition (those who fall into the 11 - 25 range) and their doctors without clear treatment guidance. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test. "So we have two yes-no answers for each gene". 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.

However, chemotherapy did offer some benefit to women aged 50 and younger who had a cancer recurrence score of 16-25, researchers found.

"We are now leaving an era where the only choice for non-small-cell lung cancer patients was to start with chemotherapy", he told reporters at the ASCO conference.

'Side effects, such as hair loss, severe pain and infertility, can be utterly devastating and linger long after they walk out the hospital doors.

According to first author Joseph Sparano of Montefiore Medical Center in NY, "any woman with early-stage breast cancer 75 or younger should have the test and discuss the results" with her doctor. It was uncertain whether the benefits of chemotherapy were enough to justify the risks and toxicity.

After years of follow up, their results were almost identical with women who received hormone therapy yielding a 93.9 per cent survival rate and those with both therapies a 93.8 per cent survival rate. Survival was similar in both groups, with over 9 in 10 women still alive 9 years after treatment. At the end of that time they found 83.3% of those on hormone therapy alone had not developed a recurrence or a second primary cancer.

The results showed that there was "no significant difference" in terms of cancer eradication or cancer recurrence between the two groups.

"We can spare thousands and thousands of women from getting toxic treatment that really wouldn't benefit them", said Dr. Ingrid A. Mayer, from Vanderbilt University Medical Center, an author of the study, as cited by The New York Times.

Thirty percent of the women in the trial did have evidence of cancer hiding in their bodies. The study also has the potential to improve access to health care by keeping costs down for women who do not need chemotherapy, Olopade said.

But Drs Sparano and Mayer added a note of caution: The data indicated that some women 50 and younger might benefit from chemo even if gene-test results suggested otherwise. The results are sure to accelerate the decline in chemotherapy for the disease. Instead, these women will likely remain in remission after having their tumors removed, and then taking estrogen-blocking hormone-therapy drugs.

The patients' tumors were analyzed using a test called Oncotype DX, which examines the activity of 21 genes to predict the risk of a recurrence over 10 years.