Published: Wed, June 06, 2018
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Breast cancer gene test could spare some women chemo

Breast cancer gene test could spare some women chemo

Baroness Delyth Morgna, chief executive of Breast Cancer Now, said: "We hope these practice-changing findings will now help refine our use of chemotherapy on the NHS".

Chemotherapy is one of the most common treatments for cancer, but a new study shows people diagnosed with one type may be able to skip it.

The study, presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, is thought to be the largest breast cancer treatment trial ever conducted.

Breast cancer is the most common form of cancer among women in the world, and hormone-receptor-positive, HER2-negative, node-negative cancer constitutes about half of the 1.7 million cases diagnosed yearly worldwide.

The study used a gene test done on tumors to help decide whether a woman would benefit from chemo or if they could receive hormone therapy. First, this is a study of just one form of breast cancer and the authors found that chemo could still benefit some patients with the cancer - mainly younger women, regardless of their tumor's genetic "score".

For those who fall in between - which includes most women - there was no clear evidence on whether they need chemotherapy.

Out of the 10,000 women enrolled in the TAILORx study, around 6,700 fell in the medium-risk range. The researchers tracked the patients' health outcomes over nine years. As welcome as the lack of spread is, it leaves patients and their doctors with a conundrum: Should they undergo chemotherapy, with the often horrendous side-effects that involves, or is surgery and hormone therapy sufficient?

It provides important information on a safe way to cut back treatment, an issue that has prompted vigorous debate not only for breast cancer but also for other malignancies.

The trail started in 2006 enrolled more than 10,000 women in the U.S. and five other countries diagnosed with early-stage breast cancer and followed their progress through post-surgery treatment.


Lead investigator Steven Rosenberg said: "Because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer".

A woman with an aggressive form of breast cancer which defied chemotherapy and spread to other organs, was cured with an experimental treatment that triggered her immune system, researchers said Monday.

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 dramatic success has raised hopes that the therapy will work in more patients with advanced breast cancer and other hard to treat cancers, such as ovarian and prostate.

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.

"You can get them to the same place... without side effects and toxicity", he said. The disease returned 10 years later, creating tumours throughout her liver and chest.

Because of her work as a nurse, she was familiar with chemotherapy's sometimes harsh effects. These come from small, early stage studies through to large randomised clinical trials.

"That's obviously huge for the individual patient". Laszlo Radvanyi, scientific director of the Ontario Institute for Cancer Research, told TheGuardian it was an "unprecedented" result, and could dawn in a completely new age of cancer treatment.

Breast cancer appears due to an uncontrolled growth on the breasts.

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