Published: Thu, June 07, 2018
Medical | By Alyssa Little

Thousands of breast cancer patients can avoid chemotherapy, landmark study says

Thousands of breast cancer patients can avoid chemotherapy, landmark study says

Findings of the past have indicated that women who met these criteria and scored below ten on the index test could safely skip chemotherapy without raising their rate of recurrence, however, those above 25 would nearly always be advised to use chemotherapy as a necessary treatment to lower risk of recurrence.

In an attempt to settle this question, investigators designed a clinical trial that assessed the long-term outcomes in women receiving radiation to their IM-MS lymph nodes compared to a control group that did not.

"Those are the cancers that have likely already metastasized and a small amount could be hiding in a woman's lung, liver or bones", said Brawley.

"The impact is tremendous", said the study's leader, Dr. Joseph Sparano of Montefiore Medical Center in NY.

"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", Sparano said in a news release from the American Society of Clinical Oncology (ASCO).

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Carrying out a commercially available 21-gene test on patients' breast tumors could allow more than two thirds of women with the most common type of early breast cancer to avoid chemotherapy, according to data from a landmark study published yesterday.

Brawley said that in addition to offering patients and doctors peace of mind about forgoing chemotherapy, the findings will prevent tens of thousands of breast cancer patients each year from the debilitating and harmful risks associated with the treatment, including hair loss, nausea, vomiting and being at risk for leukemia and congestive heart failure.

"This is a hard call when you are actually the one with the breast cancer", an early-stage breast cancer survivor from Middleton, Massachusetts, told LifeZette.

"There will still be some women that need chemotherapy".

The TAILORx trial used the Oncotype DX test, now available on the NHS, which allows doctors to predict the likelihood of the breast cancer returning.

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The Oncotype DX genetic test has been available on the NHS since 2013, but the National Institute for Health and Care Excellence (Nice) is now updating its guidance on whether it should be recommended for use. "The trial was created to address this question, and provides a very definitive answer". All had received a mid-range Oncotype DX score.

The same decade-long study had previously confirmed that patients at low risk, as determined by a genomic test of their tumors, can skip chemotherapy. "But the results came out either low risk, high risk or intermediate risk", Abraham added. The primary endpoint of the study was invasive disease-free survival - defined as invasive disease recurrence, second primary cancer, or death - measured on a non-inferiority basis.

"We know all women over 50 score 0-25 can safely take endocrine therapy without chemo therapy".

The findings will lead to a "fundamental change" in the way the disease is treated, a leading oncologist said, with an estimated 3,000 to 5,000 United Kingdom women likely to avoid chemotherapy every year as a result. "But we need to be precise on when to use it and who to recommend it to".

After nine years, 94 percent of the women in both groups were still alive. This has the potential to spare thousands of women from the terrible side effects of chemotherapy, including nausea, hair loss, and heart and nerve damage. They represent roughly half of the more than 17,000 new cases of breast cancer diagnosed in Australia every year.

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