Many don’t need chemo

Many don’t need chemo

Last Updated: June 03, 2018.

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

The test examines genes from a patient's breast cancer biopsy sample and allows doctors to assign a patient a "recurrence score" from 0 to 100, according to a news release from Loyola Medicine announcing the findings.

Rosenberg says investigators have already tested the approach in liver and colorectal cancer, but the "big picture" is that it is not cancer type-specific.

More than 60,000 women a year in the USA could be affected, according to a lead researcher Dr. Joseph A. Sparano of Montefiore Medical Center in NY, and 70 percent of patients who would be potential candidates for chemo could be spared.

A new study revealed that women with early-stage breast cancer might not need to undergo chemotherapy.

The study, published Sunday in the New England Journal of Medicine, analyzed how well a widely used genetic test assessed cancer risk, based on 21 genes linked with breast cancer recurrence.

One more thing the new findings show?

According to the TAILORx researchers, 260,000 women who are diagnosed with breast cancer each year around the world fall into the medium-risk category that wouldn't benefit from chemotherapy.

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"These data provide critical reassurance to doctors and patients that they can use genomic information to make better treatment decisions in women with early-stage breast cancer". The women in the "unfavourable" range had to receive chemotherapy.

Thousands of women have been tested over the years using Oncotype DX to help determine the true effectiveness of chemo.

All of the participants underwent surgery and hormonal therapy and half of them got chemotherapy.

But most women get an intermediate result meaning they are unclear as to what to do. "The trial was created to address this question, and provides a very definitive answer".

More than 20,000 women in the United Kingdom are diagnosed with hormone-receptor positive, HER2-negative, node-negative breast cancer annually. Women older than 50 with a midrange risk - defined in the study as a score of 11 to 25 on a tumour test - can skip chemo and just have endocrine therapy. "While this practice has contributed to declining rates in breast cancer mortality, "...the majority of patients may receive chemotherapy unnecessarily".

Based on all this, Sparano's team concluded that chemotherapy is now unwarranted in women over 50 with this type of breast cancer who have an Oncotype score under 26. She was shocked in 2010 when doctors found two tumors in one of her breasts during a mammogram. Proceeds from the U.S. Postal Service's breast cancer stamp enabled a landmark study that showed which women need chemo and which do not.

"She knew from that that the benefit of chemotherapy was very low, so she chose to not do chemotherapy, just do the hormone pill, and then also had just a short course of radiation, only three weeks instead of the standard six to seven", said Melissa Mitchell, a radiation oncologist with the University of Kansas Cancer Center. In the long term, it can cause early menopause, bone loss, chronic pain, kidney damage, and heart failure.

While chemotherapy is being dropped for some cases, it's being increased for more aggressive cancers.

Carey pointed to some "grey areas" at the boundaries of the recurrance scores that need futher investigation, and said patients would need to discuss these details with their doctors before any decisions on treatement are made.

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