More Breast Cancer Patients Can Skip Chemo - Gene Test

Adine Usher 78 meets with breast cancer study leader Dr. Joseph Sparano at the Montefiore and Albert Einstein College of Medicine in the Bronx borough of New York. Usher was one of about 10,000 participants in the study which shows women at low or inter

For some breast cancer patients, the chemo decision may now be easier

Last Updated: June 03, 2018.

While previous studies demonstrated that patients with low scores (10 or lower) did not need chemotherapy, and women with high scores (above 25) did require and benefit from chemotherapy, there was no conclusive research guiding patients and doctors on whether or not to undergo chemotherapy in cases with a tumor with a midrange score, according to the study. After surgery, one group got endocrine therapy only, while the other was treated with endocrine therapy plus chemotherapy.

The findings could be a game-changer in breast cancer care, researchers and experts said.

The study, led by the Montefiore Medical Centre in NY, found women older than 50 with this form of breast cancer and a score of up to 25 did not need chemotherapy.

The good news for around 70,000 women each year comes from the largest study done of breast cancer treatment.

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

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"I can remember sitting with patients and consenting them for this study", said Dr. Thomas W. Butler, Oncologist at USA Mitchell Cancer Institute.

The study was centered on a 21-gene test performed on tumors that has been available for breast cancer patients since the early 2000s.

Thousands of women have been tested over the years using Oncotype DX to help determine the true effectiveness of chemo. The news now means tens of thousands of women likely won't need treatment beyond surgery and hormone therapy.

Of those, 6,711 scored in the intermediate range of 11-25, and were randomly assigned hormone therapy alone or hormone therapy plus chemotherapy. "The trial was created to address this question, and provides a very definitive answer".

However, the results of the TAILORx trial show that only 30% of women with this particular form of early-stage breast cancer benefit from the treatment.

The patients then went on to receive either hormonal therapy alone or the combo of hormonal therapy plus chemotherapy.

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Until now, chemotherapy was highly recommended with a result greater than 25, and below 10 it was not. It showed most patients with an intermediate risk of cancer recurrence can avoid chemotherapy without hurting their chances of beating the disease.

"We have been waiting for these results for years", said Allison Kurian, an oncologist at Stanford University who wasn't involved in the trial. Even after two years, she is still cancer-free.

For women 50 or younger, chemotherapy is unwarranted for those with an Oncotype score under 16 - about 40 percent of breast cancers in this age group, the researchers said. They benefit just as much from chemotherapy, which many don't tolerate well and can have long-term consequences, as they do from hormone treatments, which have many fewer side effects.

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

"This study gives us information on a very specific group of women with a very specific type of cancer", she said, "but it doesn't tell us chemotherapy is not effective in some cases".

The study was supported by the National Cancer Institute, the American College of Surgeons, Cancer and Leukemia Group B, NSABP Foundation, NCIC Clinical Trials Group, North Central Cancer Treatment Group, and Southwest Oncology Group.

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